Doctor Name: | MR. JASON SALVADOR ROSALES |
NPI Number: | 1689794976 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LICENSED PSYCH TECH |
License Number: | PT29038 |
Business Practice Address: | 1212 N California St Stockton, CA - 952021552 |
Business Phone Number: | 2094683760 |
Business Fax Number: | 2094683779 |
Mailing Address: | 1233 Shadow Creek Dr, STOCKTON |
State: | CA |
Postal Code: | 952091426 |
Phone Number: | 2094683760 |
Fax Number: | 2094683779 |
NPI Enumeration Date: | 03/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 167G00000X |
License Number: | PT29038 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Psychiatric Technician |
Taxonomy Specialization: | |
Taxonomy Definition: | 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 disorders and developmental disabilities. |