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General NPI Number Information
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NPI Number | 1396866240
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Entity Type | Individual
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Provider Name | ALEXANDER PILKINTON III PSCHY. TECH.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1701 W KANAI AVE
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City | PORTERVILLE
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State | CA
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Zip | 93257-1873
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Country | US
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Telephone | 559-782-8136
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Fax |
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Provider Business Mailing Address
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Address Line | 551 N FUR WAY
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City | PORTERVILLE
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State | CA
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Zip | 93257
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Country | US
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Telephone | 559-781-8597
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 167G00000X
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Taxonomy Name | Licensed Psychiatric Technician
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License Number | PT23549
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License Number State | CA
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