Active NPI
Herbert Cebollero, PT
- Licensed Psychiatric Technician
- Santa Monica, CA
National Provider Identifier
1962584862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- License
- PT19401
- Practice address
- 1328 2ND St
Santa Monica, CA 90401-1122 - Phone
- (310) 394-6889
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- 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 | PT19401 | CA | Primary |
Addresses
Primary practice location
1328 2ND St
Santa Monica, CA 90401-1122
Mailing address
1328 2ND St
Santa Monica, CA 90401-1122
Phone (310) 394-6889
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 |
|---|---|---|---|
| PT19401 | CA | MD | Licensed Psychiatric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1962584862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1328 2ND ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904011122",
"telephone_number": "310-394-6889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1328 2ND ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904011122",
"telephone_number": "310-394-6889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CEBOLLERO",
"first_name": "HERBERT",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "PT19401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.