Nina Gabriele Sitompul

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

PT33479 Issued in CA

Practice address

2500 Wilshire Blvd
Los Angeles, CA 90057-4303

Phone

(213) 639-2660

NPI assigned

May 25, 2012

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

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337904000000",
    "number": "1861752677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10593 HORSESHOE DR",
            "city": "BLOOMINGTON",
            "state": "CA",
            "postal_code": "923162767",
            "telephone_number": "909-714-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900574303",
            "telephone_number": "213-639-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITOMPUL",
        "first_name": "NINA",
        "middle_name": "GABRIELE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT33479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Sisti, MD
• Ricardo Sistos, MD
• Erwinn Martin C Sistoza, M.D.
• Christina Sitan
• Georges Sitjar-Sargent
• Linda Sittler, PMHNP BC
• Paula L. Situ, N.P.
• Robert Situ, MD
• Wesley Yuk Yan Situ
• Sarina Sity

• Licensed Psychiatric Technician in Los Angeles, CA
• Providers in Los Angeles, 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 May 25, 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.

Verify at the official NPI Registry.