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NPI Code Detail

MEDICARE: MS. LYNETTE DEE EWING PSYCHIATRIC TECH.

MEDICARE: MS. LYNETTE DEE EWING PSYCHIATRIC TECH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1167G00000XLicensed Psychiatric TechnicianPT30680CA

General Provider Information

NPI Number : 1144327842
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LYNETTE DEE EWING PSYCHIATRIC TECH.
Provider Business Mailing Address
First Line : 15573 RICHVALE DR
Second Line :
City : WHITTIER
State : CA
Zip : 90604-3253
Country : US
Telephone Number : 562-943-0692
Fax Number :
Provider Business Practice Location Address
First Line : 1030 W WARNER AVE
Second Line :
City : SANTA ANA
State : CA
Zip : 92707-3147
Country : US
Telephone Number : 714-834-6900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2006
Last Update Date : 07/08/2007

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