Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dannie Nainggolan

Individual provider Licensed Psychiatric Technician · NPI 1174388375

Dannie Nainggolan is a Licensed Psychiatric Technician in Riverside, California. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

17270 Roosevelt St
Riverside, CA 92508-9523
Phone: (951) 780-2514
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Psychiatric Technician (primary) Taxonomy 167G00000X

Record details

NPI number1174388375
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 16, 2024
Last updated in NPPESJuly 30, 2025
Certification dateJuly 30, 2025
Mailing address5870 Arlington Ave, Riverside, CA 92504-2037

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