Active NPI
Kristen Nicole Daveiga
- Licensed Psychiatric Technician
- Fresno, CA
National Provider Identifier
1639445695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- License
- 36212
- Practice address
- 1225 M St
Correctional Health, 2ND Floor
Fresno, CA 93721-1805 - Phone
- (559) 442-2404
- Fax
- (559) 442-5277
- NPI assigned
- Mar 23, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Psychiatric Technician | 167G00000X | 36212 | CA | Primary |
Addresses
Primary practice location
1225 M St
Correctional Health, 2ND Floor
Fresno, CA 93721-1805
Mailing address
PO Box 11867
Correctional Health
Fresno, CA 93775-1867
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 |
|---|---|---|---|
| 36212 | CA | MD | Dental Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Fresno | Past | Accepting new patients | |
| County of Fresno | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332460800000",
"number": "1639445695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11867",
"address_2": "CORRECTIONAL HEALTH",
"city": "FRESNO",
"state": "CA",
"postal_code": "937751867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 M ST",
"address_2": "CORRECTIONAL HEALTH, 2ND FLOOR",
"city": "FRESNO",
"state": "CA",
"postal_code": "937211805",
"telephone_number": "559-442-2404",
"fax_number": "559-442-5277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVEIGA",
"first_name": "KRISTEN",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-23",
"last_updated": "2012-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "36212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.