Individual provider · Type 1 NPI

Tyda Viveros

Licensed Psychiatric Technician · Stockton, CA

NPI number 1063946002 Active

Practice location

1111 N El Dorado St
Stockton, CA 95202-1305

Call (209) 938-0228 Map

Fax (209) 938-0281

Mailing address

1111 N. Eldorado Street
Stockton, CA 95202

Specialties and licenses

TaxonomyCodeLicense
Licensed Psychiatric Technician Primary 167G00000X37052 (CA)

Licensed Psychiatric Technician: An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental dis…

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About NPI 1063946002

Tyda Viveros's National Provider Identifier is 1063946002, issued on Apr 17, 2017. The primary taxonomy on file is Licensed Psychiatric Technician (167G00000X), and the practice location is in Stockton, CA. The record was last updated on Apr 17, 2017.