National Provider Identifier Database

DENISE BLACK
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 disorders and developmental disabilities.


Contact Information

DENISE BLACK
327 COLLEGE AVE
SANTA ROSA, CA95401-5117
Phone: 707-568-2800
Fax: 707-568-2804
Website:
Specialty Taxonomy Code
* Licensed Psychiatric Technician 167G00000X

* Indicates primary specialty

NPI Profile & details for DENISE BLACK

NPI Number 1194029371
Credentials
Entity Individual
Enumeration date 01/03/2011
Last updated 01/03/2011 - About 15 years ago
Sole proprietor1 No
Identifiers
  • CA License #: PT35099
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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