MR. BRUCE BLACK PSYCH TECH
NPI 1285185819
Licensed Psychiatric Technician in Santa Rosa, CA
NPI Status: Active since October 19, 2016
Contact Information
2225 CHALLENGER WAY
SANTA ROSA, CA
ZIP 95407
Phone: (707) 576-8181
- Individual
- Male
- Licensed Psychiatric Technician
About BRUCE BLACK
This page provides the complete NPI Profile along with additional information for Bruce Black, a provider established in Santa Rosa, California with a medical specialization in Licensed Psychiatric Technician. The healthcare provider is registered in the NPI registry with number 1285185819 assigned on October 2016. The practitioner's primary taxonomy code is 167G00000X with license number PT 31504 (CA). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1285185819
- Provider Name
- MR. BRUCE BLACK PSYCH TECH
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2225 CHALLENGER WAY SANTA ROSA, CA 95407
- Location Phone
- (707) 576-8181
- Mailing Address
- 2225 CHALLENGER WAY SANTA ROSA, CA 95407
- Mailing Phone
- (707) 576-8181
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-19-2016
- Last Update Date
- 10-19-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Licensed Psychiatric Technician
- Taxonomy Code
- 167G00000X
- Type
- Nursing Service Providers
- License No.
- PT 31504
- License State
- CA
- Taxonomy Description
- 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.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 8 | 5 | 1 | 8 | 5 | 8 | 1 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 16 | 5 | 2 | 8 | 10 | 8 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 6 + 5 + 2 + 8 + 1 + 0 + 8 + 2 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1285185819 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1003940065 | RACHEL J AVILA Individual | Counselor (Addiction (Substance Use Disorder)) | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-5510 |
| 1295129575 | MS. ELIZABETH DONOHUE M.A., LMFT Individual | Marriage & Family Therapist | 2225 CHALLENGER WAY ACCESS TEAM SANTA ROSA, CA 95407 (707) 565-4981 |
| 1437601093 | YOLANDA M. SPENCER LVN, CPT1 Individual | Licensed Vocational Nurse | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-4850 |
| 1831630847 | GENAI RENZ LVN Individual | Licensed Vocational Nurse | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 576-8181 |
| 1033262654 | MRS. LUCILLE A CAPO ROME NP Individual | Registered Nurse (Psychiatric/Mental Health, Adult) | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-6625 |
| 1326575689 | AARON O QUINONES SOSA LVN Individual | Licensed Vocational Nurse | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 576-8181 |
| 1861915498 | STEPHEN WILSEY LEUPOLD Individual | Marriage & Family Therapist | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-4970 |
| 1154399723 | DR. LISA ANN MORAN M.D. Individual | Psychiatry & Neurology (Psychiatry) | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-4970 |
| 1336655695 | JASON MICHAEL KING LVN Individual | Licensed Vocational Nurse | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-4101 |
| 1992159230 | DAVID AMBER Individual | Registered Nurse (Psychiatric/Mental Health) | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (772) 475-4062 |
| 1407137078 | MATTHEW JOHN ELIAS Individual | Marriage & Family Therapist | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-4922 |
| 1114412376 | DYLAN GRIEVE Individual | Registered Nurse (Psychiatric/Mental Health) | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 576-8181 |
| 1063977460 | GARDNER CARLSON Individual | Licensed Psychiatric Technician | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-4970 |
| 1255898524 | CAROL LYNN GALIPO RN Individual | Registered Nurse | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-6900 |
| 1174025076 | JAMELL BAXTER REGISTERED NURSE Individual | Registered Nurse (Psychiatric/Mental Health) | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-6900 |
| 1932763596 | MONICA KIDD RN Individual | Registered Nurse (Psychiatric/Mental Health) | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-4101 |
| 1114164027 | LESLIE KARIN HARFORD PA-C Individual | Physician Assistant | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-4970 |
| 1336772540 | JILLIAN LEACH RN Individual | Registered Nurse | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-4970 |
| 1528693363 | ERICA ADELE HARTMAN RN Individual | Registered Nurse | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-4101 |
| 1851554588 | DR. CYNTHIA ALLENA PILGRIM M.D. Individual | Psychiatry & Neurology (Psychiatry) | 2225 CHALLENGER WAY SANTA ROSA, CA 95407 (707) 565-4850 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1285185819, enumerated in the NPI registry as an "individual" on October 19, 2016
The provider is located at 2225 Challenger Way Santa Rosa, Ca 95407 and the phone number is (707) 576-8181
The provider's speciality is Licensed Psychiatric Technician with taxonomy code 167G00000X
This NPI record was last updated on October 19, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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