Susana Oliva Mena, LPT

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

40387 Issued in CA

Practice address

5200 San Gabriel PL Ste C
Pico Rivera, CA 90660-2498

Phone

(562) 222-1331

Fax

(562) 222-1322

NPI assigned

Jul 14, 2017

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1982126579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 SAN GABRIEL PL STE C",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602498",
            "telephone_number": "562-222-1331",
            "fax_number": "562-222-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 SAN GABRIEL PL STE C",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602498",
            "telephone_number": "562-222-1331",
            "fax_number": "562-222-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENA",
        "first_name": "SUSANA",
        "middle_name": "OLIVA",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "40387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Psychiatric Technician in Pico Rivera, CA
• Providers in Pico Rivera, 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 Jul 21, 2022; 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.