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

Individual provider Licensed Psychiatric Technician · NPI 1285185819

Mr. Bruce Black, PSYCHTECH is a Licensed Psychiatric Technician in Santa Rosa, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2016
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Practice location Address checks out

2225 Challenger Way
Santa Rosa, CA 95407
Phone: (707) 576-8181
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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 · Licence PT 31504 (CA)

Record details

NPI number1285185819
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYCHTECH
Sole proprietorYes
NPI enumeratedOctober 19, 2016
Last updated in NPPESOctober 19, 2016
Mailing address2225 Challenger Way, Santa Rosa, CA 95407-5441

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