Deleon Devaughn, LPT
Individual provider Active NPI Licensed Psychiatric Technician · Coalinga, CA
NPI 1740901230 · NPPES record last updated Sep 5, 2022
Key facts
- NPI
- 1740901230
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Psychiatric Technician 167G00000X
- License
- 41083 (CA)
- Practice address
- 232 E Houston St
Coalinga, CA 93210-2614 - Phone
- (626) 644-5665
- NPI assigned
- Sep 5, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Psychiatric Technician | 167G00000X | 41083 | CA | Yes |
Addresses
Primary practice location
232 E Houston St
Coalinga, CA 93210-2614
Mailing address
232 E Houston St
Coalinga, CA 93210-2614
Phone (626) 644-5665
Other providers in Coalinga, CA
- Frieda Dehnavifar
- Department of State Hospital Coalinga
- Department of State Hospital Coalinga
- Department of State Hospitals
- Tracy Dern
- David Dinishak
- Lamberto Samodio Domingo
- Kwame A Donkor
- Afshin Dowlatshahi
- Dr Bonnie Wagner
All providers in Coalinga, CA · Licensed Psychiatric Technician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.