Individual provider · NPI-1

Tyrone Desaussure Sr., LPT

Licensed Psychiatric Technician · Santa Maria, CA

NPI number1699603514
StatusActive
Last updated in NPPESMay 11, 2026

Details

NPI
1699603514
Entity type
Individual (NPI-1)
Name
Tyrone Desaussure Sr.
Credential
LPT
Sex
Male
Sole proprietor
No
Enumeration date
May 11, 2026
Certification date
May 11, 2026
Last updated
May 11, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
167G00000X Licensed Psychiatric Technician36679CAYes

Practice location

212 Carmen Ln Ste 201
Santa Maria, CA 93458-7771

Phone 805-212-7680

Mailing address

212 Carmen Ln Ste 201
Santa Maria, CA 93458-7771

Phone 808-212-7680

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