MICHAEL JOHN MICHAELIDES JR.
NPI 1003163270
Licensed Psychiatric Technician in Los Angeles, CA

Q: What is the provider's specialty?

The provider's specialty is Licensed Psychiatric Technician with taxonomy code 167G00000X.

Active since August 07, 2012

679 S NEW HAMPSHIRE AVE STE 400, LOS ANGELES, CA 90005(213) 639-2500 Get Directions Write a Review

NPPES record last updated: February 28, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 28, 2023, Mar 7, 2018 (2 updates tracked since 2018).

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About Michael John Michaelides Jr. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL JOHN MICHAELIDES JR. (NPI 1003163270) is an individual licensed psychiatric technician in Los Angeles, California, licensed in California (LPT42462) and active in the NPI registry since August 2012. He maintains a secondary practice location in Azusa.

NPPES Registry Identity

NPI1003163270

Entity TypeIndividualMale

Primary Taxonomy167G00000X

Provider Legal NameMICHAEL JOHN MICHAELIDES JR.

Location Address679 S NEW HAMPSHIRE AVE STE 400Los Angeles, CA 90005-1355

Mailing Address679 S New Hampshire Ave Ste 400Los Angeles, CA 90005-1355 · (213) 639-2500

Phone(213) 639-2500

Sole ProprietorYes

Enumeration DateAugust 7, 2012

Last NPPES UpdateFebruary 28, 20232 updates tracked since enumeration

NPPES CertifiedFebruary 28, 2023

✔ NPI 1003163270 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyLicensed Psychiatric TechnicianNursing Service Providers

Taxonomy Code167G00000X

License✔ Licensed in CA · LPT42462

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.

Also ListedRehabilitation PractitionerTaxonomy 225400000X

679 S NEW HAMPSHIRE AVE STE 400, Los Angeles, CA 90005

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