William Wade Middleton, LPT/PET CLINICIAN

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

PT26958 Issued in CA

Practice address

3630 E Imperial Hwy
Lynwood, CA 90262-2609

Phone

(301) 900-8210

Fax

(310) 900-8286

NPI assigned

Jun 4, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1922488923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 OLIVE AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926484809",
            "telephone_number": "714-591-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 E IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622609",
            "telephone_number": "301-900-8210",
            "fax_number": "310-900-8286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25352 Hillary Ln",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926535217",
            "country_code": "US",
            "telephone_number": "949-652-5351",
            "fax_number": "949-652-5361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "WILLIAM",
        "middle_name": "WADE",
        "credential": "LPT/PET CLINICIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PT26958",
            "primary": false
        },
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT26958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADDTAXONMY",
            "identifier": "167G00000X",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245227180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvonne Mendoza
• Gabriela Merida
• Cecelyn Meza
• Michael Angel Jimenez, MD, Inc.
• Michael B. Scott, M.D., Inc.
• Dolores Jean Miguel, LCSW
• Carl Milburn
• Jaquenette Miller
• Jerome Miller
• Joel Clinton Miller, M.D.

• Licensed Psychiatric Technician in Lynwood, CA
• Providers in Lynwood, 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 Aug 28, 2019; 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.