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Mr. Anthony Desanto-kelly, LICENSEPYSCHTECH3
Licensed Psychiatric Technician in Long Beach, California
NPI 1417047069

Anthony Desanto-kelly is a Licensed Psychiatric Technician based in Moreno Valley, CA. Anthony Desanto-kelly practices in Long Beach, CA and has the professional credentials of LICENSEPYSCHTECH3. The NPI Number for Anthony Desanto-kelly is 1417047069 and holds a License No. PT24452 (California).

The current practice location address for Anthony Desanto-kelly is 3501 N Lakewood Blvd, Long Beach, CA and can be reached out via phone at 562-570-7119. You can also correspond with Anthony Desanto-kelly through the mailing address at 12857 FREDERICK ST APT 304, MORENO VALLEY, CA - 92553-4502 (mailing address contact number: 951-653-3141).

Location: 3501 N Lakewood Blvd, Long Beach, CA, 92553-4502
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417047069
Provider Name
Anthony Desanto-kelly
Credential
LICENSEPYSCHTECH3
Provider Entity Type
Individual
Gender
Male
Address
3501 N Lakewood Blvd, Long Beach, CA, 92553-4502
Phone Number
562-570-7119
Fax Number
Provider Enumeration Date
10/13/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
3501 N Lakewood Blvd
City
Long Beach
State
California
Zip
90808-1736
Phone Number
562-570-7119
Fax Number
person
Provider Business Mailing Address Details
Address
12857 Frederick St Apt 304
City
Moreno Valley
State
California
Zip
92553-4502
Phone Number
951-653-3141
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Psychiatric Technician
Speciality
-
Taxonomy
167G00000X
License No.
PT24452 (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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