Individual provider · Type 1 NPI

Maryknoll Antonio Ponce

Licensed Psychiatric Technician · Stockton, CA

NPI number 1649068024 Active

Practice location

1212 N California St
Stockton, CA 95202-1552

Call (209) 468-8700 Map

Specialties and licenses

TaxonomyCodeLicense
Licensed Psychiatric Technician Primary 167G00000X42390 (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 1649068024

Maryknoll Antonio Ponce's National Provider Identifier is 1649068024, issued on Apr 28, 2025. 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 28, 2025.