Active NPI
Loni Isham
- Licensed Psychiatric Technician
- Ripon, CA
National Provider Identifier
1891145033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- License
- 38233
- Practice address
- 511 Rustic CT
Ripon, CA 95366-9507 - Phone
- (209) 612-8609
- NPI assigned
- Jun 19, 2016
- Last updated
- Jun 19, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 38233 | CA | Primary |
Addresses
Primary practice location
511 Rustic CT
Ripon, CA 95366-9507
Mailing address
511 Rustic CT
Ripon, CA 95366-9507
Phone (209) 612-8609
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 |
|---|---|---|---|
| 38233 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466294400000",
"number": "1891145033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 RUSTIC CT",
"city": "RIPON",
"state": "CA",
"postal_code": "953669507",
"telephone_number": "209-612-8609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 RUSTIC CT",
"city": "RIPON",
"state": "CA",
"postal_code": "953669507",
"telephone_number": "209-612-8609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISHAM",
"first_name": "LONI",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-19",
"last_updated": "2016-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "38233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ripon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.