Tammy Ann Javonillo, LICENSED PSYCH TECH

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

PT34326 Issued in CA

Practice address

2600 Redondo Ave
Long Beach, CA 90806-2325

Phone

(562) 256-2900

Fax

(562) 290-0074

NPI assigned

Aug 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1972794485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 REDONDO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062325",
            "telephone_number": "562-256-2900",
            "fax_number": "562-290-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 REDONDO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062325",
            "telephone_number": "562-256-2900",
            "fax_number": "562-290-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVONILLO",
        "first_name": "TAMMY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LICENSED PSYCH TECH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT34326",
            "primary": true
        },
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Javidinejad, O.D.
• John B Javien, MD
• Denesse Javier, PHARMD
• Joseph Javier, RCP, RRT
• Kelly Javonillo
• John Bruce Jay, MAMFT
• Peter Dawson Jay, PH.D.
• Mahinda A Jayaratna, MD
• Surani Amala Jayaratna
• George M Jayatilaka, M.D.

• Licensed Psychiatric Technician in Long Beach, CA
• Providers in Long Beach, 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 Jun 9, 2021; 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.