Individual provider · Type 1 NPI

Dannie Nainggolan

Licensed Psychiatric Technician · Riverside, CA

NPI number 1174388375 Active

Practice location

17270 Roosevelt St
Riverside, CA 92508-9523

Call (951) 780-2514 Map

Mailing address

5870 Arlington Ave
Riverside, CA 92504-2037

Specialties and licenses

TaxonomyCodeLicense
Licensed Psychiatric Technician Primary 167G00000XNone listed

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 1174388375

Dannie Nainggolan's National Provider Identifier is 1174388375, issued on Feb 16, 2024. The primary taxonomy on file is Licensed Psychiatric Technician (167G00000X), and the practice location is in Riverside, CA. The record was last updated on Jul 30, 2025.