NPI 1033092564

Vidian Anastasya Pangalila

Practitioner Licensed Psychiatric Technician Colton, CA

Practice location

Address: 400 N Pepper Ave, Colton, CA 92324-1819
Phone: (909) 580-1800

Registered specialties

Licensed Psychiatric Technician Primary

Nursing Service Providers Taxonomy 167G00000X Licence 42954 (CA)

Other Licensed Psychiatric Technician providers in California →

Registry record

NPI: 1033092564
Entity type: Individual
Sex (as registered): X
NPI issued: 30 Jul 2025
Record last updated: 30 Jul 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.