Robert Ken Ota

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

33792 Issued in CA

Practice address

1212 N California St
Stockton, CA 95202-1552

Phone

(209) 468-8660

NPI assigned

Apr 10, 2007

Last updated

Jan 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1578786554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 WAGNER HEIGHTS RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952094868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021552",
            "telephone_number": "209-468-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTA",
        "first_name": "ROBERT",
        "middle_name": "KEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "33792",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abha M Oshtory, MD
• Meherji A Oshtory, MD
• Marilyn Garlejo Osias, NP
• Mohamednoor A Osman, MD
• Calvin K. Ota, DDS
• Steven Mikkio Otani, D.D.S.
• Robert Christopher Pestano Ote, M.D.
• Luis Otero
• Larry George Otterstetter, DO
• Sarah Otto

• Licensed Psychiatric Technician in Stockton, CA
• Providers in Stockton, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.