1. Home
  2. Directory
  3. California
  4. Riverside
  5. Licensed Psychiatric Technician
  6. NPI Profile

DANNIE NAINGGOLAN
NPI 1174388375
Licensed Psychiatric Technician in Riverside, CA

Active since February 16, 2024
17270 ROOSEVELT ST, RIVERSIDE, CA 92508(951) 780-2514 Get Directions Write a Review

NPPES record last updated: July 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dannie Nainggolan NPPES

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

DANNIE NAINGGOLAN (NPI 1174388375) is an individual licensed psychiatric technician in Riverside, California and active in the NPI registry since February 2024.

NPPES Registry Identity

NPI1174388375
Entity TypeIndividualMale
Primary Taxonomy167G00000X
Provider Legal NameDANNIE NAINGGOLAN
Location Address17270 ROOSEVELT STRiverside, CA 92508-9523
Mailing Address5870 Arlington AveRiverside, CA 92504-2037 · (951) 683-6596 · Fax (951) 373-5992
Phone(951) 780-2514
Sole ProprietorNo
Enumeration DateFebruary 16, 2024
Last NPPES UpdateJuly 30, 2025
NPPES CertifiedJuly 30, 2025
✔ NPI 1174388375 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Psychiatric TechnicianNursing Service Providers
Taxonomy Code167G00000X
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.
17270 ROOSEVELT ST, Riverside, CA 92508
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JAMIKA JACKSON
Licensed Psychiatric Technician
17270 ROOSEVELT ST
RIVERSIDE, CA 92508
Riverside County (951) 683-6596
BRANDON WALTER OARE
Counselor (Addiction (Substance Use Disorder))
17270 ROOSEVELT ST
RIVERSIDE, CA 92508
Riverside County (951) 780-2541
ANGELO MARTIN SANCHEZ
Counselor (Addiction (Substance Use Disorder))
17270 ROOSEVELT ST
RIVERSIDE, CA 92508
Riverside County (951) 683-6596
MR. EDGAR LOUIS BORNE III
Counselor (Professional)
17270 ROOSEVELT ST
RIVERSIDE, CA 92508
Riverside County (951) 683-6596
SEAN MICHAEL GILBERT
Counselor (Addiction (Substance Use Disorder))
17270 ROOSEVELT ST
RIVERSIDE, CA 92508
Riverside County (951) 683-6596
DOUGLAS WADE PALMER JR.
Counselor (Addiction (Substance Use Disorder))
17270 ROOSEVELT ST
RIVERSIDE, CA 92508
Riverside County (951) 683-6596
URIAH MATTIA
Counselor (Addiction (Substance Use Disorder))
17270 ROOSEVELT ST
RIVERSIDE, CA 92508
Riverside County (951) 683-6596
CARLOS JACOBO ADAME
Licensed Psychiatric Technician
17270 ROOSEVELT ST
RIVERSIDE, CA 92508
Riverside County (951) 683-6596

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dannie Nainggolan's NPI number?

The NPI number for Dannie Nainggolan is 1174388375. It was assigned to this individual provider in the NPPES registry on February 16, 2024.

Where is Dannie Nainggolan located?

Dannie Nainggolan practices at 17270 Roosevelt St, Riverside, CA 92508. The listed phone number is (951) 780-2514.

What is Dannie Nainggolan's specialty?

The primary specialty registered for this NPI is Licensed Psychiatric Technician with taxonomy code 167G00000X.

When was this NPI record last updated?

The NPPES record for Dannie Nainggolan was last updated on July 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.