Active NPI
Kathleen Marie Razmek
- Licensed Psychiatric Technician
- Clearlake, CA
National Provider Identifier
1801959176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- License
- PT25336
- Practice address
- 15145A Lakeshore Dr
Clearlake, CA 95422-8106 - Phone
- (707) 994-7090
- NPI assigned
- Dec 18, 2006
- 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 | PT25336 | CA | Primary |
Addresses
Primary practice location
15145A Lakeshore Dr
Clearlake, CA 95422-8106
Mailing address
4683 Hawaina Way
Kelseyville, CA 95451-9757
Phone (707) 277-0534
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 |
|---|---|---|---|
| PT25336 | CA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801959176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4683 HAWAINA WAY",
"city": "KELSEYVILLE",
"state": "CA",
"postal_code": "954519757",
"telephone_number": "707-277-0534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15145A LAKESHORE DR",
"city": "CLEARLAKE",
"state": "CA",
"postal_code": "954228106",
"telephone_number": "707-994-7090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAZMEK",
"first_name": "KATHLEEN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "PT25336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearlake, 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.