Active NPI
Vernice Sally Mohr, PSY TECH
- Licensed Psychiatric Technician
- Lodi, CA
National Provider Identifier
1801919519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- License
- 21167
- Practice address
- 1209 W Tokay St
Suite 5
Lodi, CA 95240-3845 - Phone
- (209) 331-2070
- Fax
- (209) 331-2077
- NPI assigned
- Apr 9, 2007
- 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 | 21167 | CA | Primary |
Addresses
Primary practice location
1209 W Tokay St
Suite 5
Lodi, CA 95240-3845
Mailing address
416 Concord St
Lodi, CA 95240-5317
Phone (209) 331-2070
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 |
|---|---|---|---|
| 21167 | CA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of San Joaquin | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Manteca, CA
- NPI 1417407636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801919519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 CONCORD ST",
"city": "LODI",
"state": "CA",
"postal_code": "952405317",
"telephone_number": "209-331-2070",
"fax_number": "209-331-2077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1209 W TOKAY ST",
"address_2": "SUITE 5",
"city": "LODI",
"state": "CA",
"postal_code": "952403845",
"telephone_number": "209-331-2070",
"fax_number": "209-331-2077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHR",
"first_name": "VERNICE",
"middle_name": "SALLY",
"name_prefix": "Mrs.",
"credential": "PSY TECH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "21167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.