Provider Demographics
NPI:1003452798
Name:ABEL, FELECIA KATHREEN (PSYCHIATRIC TECH)
Entity Type:Individual
Prefix:
First Name:FELECIA
Middle Name:KATHREEN
Last Name:ABEL
Suffix:
Gender:F
Credentials:PSYCHIATRIC TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 NEVADA ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2957
Mailing Address - Country:US
Mailing Address - Phone:909-792-0747
Mailing Address - Fax:909-792-1058
Practice Address - Street 1:1030 NEVADA ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2957
Practice Address - Country:US
Practice Address - Phone:909-792-0747
Practice Address - Fax:909-792-9687
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT30805167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician