Stephanie Vickers

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

30787 Issued in CA

Practice address

36 S Kinneloa Ave
Suite 200
Pasadena, CA 91107-3853

Phone

(626) 844-3033

NPI assigned

Jul 31, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rosemary Children'S Services

  • Community/Behavioral Health Agency
  • Pasadena, CA
  • NPI 1689972846
  NPD (past)

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1679959696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 S KINNELOA AVE",
            "address_2": "SUITE 200",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073853",
            "telephone_number": "626-844-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 S KINNELOA AVE",
            "address_2": "SUITE 200",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073853",
            "telephone_number": "626-844-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "30787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Marie Verrette, MD
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• Vertex Hospice and Palliative Care
• Tommy VI
• Savannah Vick
• Vicki H. Wang Dental Corporation
• Victor Treatment Centers, Inc.
• Victor Treatment Centers, Inc.
• Victor Treatment Centers, Inc.
• Victor Treatment Centers, Inc.

• Licensed Psychiatric Technician in Pasadena, CA
• Providers in Pasadena, 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 Jul 31, 2015; 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.