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Mr. Bruce Black, PSYCHTECH
Licensed Psychiatric Technician in Santa Rosa, California
NPI 1285185819

Bruce Black is a Licensed Psychiatric Technician based in Santa Rosa, CA. Bruce Black practices in Santa Rosa, CA and has the professional credentials of PSYCHTECH. The NPI Number for Bruce Black is 1285185819 and holds a License No. PT 31504 (California).

The current practice location address for Bruce Black is 2225 Challenger Way, Santa Rosa, CA and can be reached out via phone at 707-576-8181. You can also correspond with Bruce Black through the mailing address at 2225 CHALLENGER WAY, SANTA ROSA, CA - 95407-5441 (mailing address contact number: 707-576-8181).

Location: 2225 Challenger Way, Santa Rosa, CA, 95407-5441
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1285185819
Provider Name
Bruce Black
Credential
PSYCHTECH
Provider Entity Type
Individual
Gender
Male
Address
2225 Challenger Way, Santa Rosa, CA, 95407-5441
Phone Number
707-576-8181
Fax Number
Provider Enumeration Date
10/19/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2225 Challenger Way
City
Santa Rosa
State
California
Zip
95407
Phone Number
707-576-8181
Fax Number
person
Provider Business Mailing Address Details
Address
2225 Challenger Way
City
Santa Rosa
State
California
Zip
95407
Phone Number
707-576-8181
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Psychiatric Technician
Speciality
-
Taxonomy
167G00000X
License No.
PT 31504 (California)
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.
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