Active NPI
Bernardo Camilo Cavalcante
- Licensed Psychiatric Technician
- Martinez, CA
National Provider Identifier
1568940690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- License
- 41332
- Practice address
- 25 Allen Street
Martinez, CA 94553 - Phone
- (925) 375-9278
- NPI assigned
- Jul 31, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Licensed Psychiatric Technician | 167G00000X | 41332 | CA | Primary |
Addresses
Primary practice location
25 Allen Street
Martinez, CA 94553
Mailing address
25 Allen Street
Suite B
Martinez, CA 94553
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41332 | CA | MD | Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698192000000",
"number": "1568940690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 ALLEN STREET",
"address_2": "SUITE B",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "94553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 ALLEN STREET",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "94553",
"telephone_number": "925-375-9278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMILO CAVALCANTE",
"first_name": "BERNARDO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-31",
"last_updated": "2023-10-25",
"certification_date": "2023-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "41332",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.