JUSTEN DAKOTA LEAGUE LPT
NPI 1245965888
Licensed Psychiatric Technician in San Luis Obispo, CA

Q: What is Justen League's NPI number?

The NPI number for Justen League is 1245965888. It was assigned to this individual provider in the NPPES registry on July 18, 2022.

Q: What is Justen League's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Justen League was last updated on January 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since July 18, 2022

2975 MCMILLAN AVE STE 164, SAN LUIS OBISPO, CA 93401(805) 439-4890 Get Directions Write a Review

NPPES record last updated: January 3, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 3, 2025, Jul 18, 2022 (2 updates tracked since 2022).

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About Justen Dakota League Lpt NPPES

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

JUSTEN DAKOTA LEAGUE LPT (NPI 1245965888) is an individual licensed psychiatric technician in San Luis Obispo, California, licensed in California (41076) and active in the NPI registry since July 2022. He maintains a secondary practice location in San Luis Obispo.

NPPES Registry Identity

NPI1245965888

Entity TypeIndividualMale

Primary Taxonomy167G00000X

Provider Legal NameJUSTEN DAKOTA LEAGUECredential: LPT

Location Address2975 MCMILLAN AVE STE 164San Luis Obispo, CA 93401-6768

Mailing Address2178 Johnson AveSan Luis Obispo, CA 93401-4535 · (805) 781-4700

Phone(805) 439-4890

Sole ProprietorYes

Enumeration DateJuly 18, 2022

Last NPPES UpdateJanuary 3, 20252 updates tracked since enumeration

NPPES CertifiedJanuary 3, 2025

✔ NPI 1245965888 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Psychiatric TechnicianNursing Service Providers

Taxonomy Code167G00000X

License✔ Licensed in CA · 41076

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.

2975 MCMILLAN AVE STE 164, San Luis Obispo, CA 93401

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Secondary Practice Location 1

Location 12178 Johnson AveSan Luis Obispo, CA 93401-4535 · Phone (805) 781-4700

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.

BETHANY J SHAKESPEARE MS, LMFT

Marriage & Family Therapist