Individual provider · Type 1 NPI
Bruce Black, PSYCH TECH
Licensed Psychiatric Technician · Santa Rosa, CA
Practice location
2225 Challenger Way
Santa Rosa, CA 95407
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Licensed Psychiatric Technician Primary | 167G00000X | PT 31504 (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 1285185819
Bruce Black, PSYCH TECH's National Provider Identifier is 1285185819, issued on Oct 19, 2016. The primary taxonomy on file is Licensed Psychiatric Technician (167G00000X), and the practice location is in Santa Rosa, CA. The record was last updated on Oct 19, 2016.