Lauren Elvira Mirabdollah, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95000334 Issued in CA

Practice address

77 Casa St
Suite 201-204
San Luis Obispo, CA 93405-5803

Phone

(805) 269-1500

Fax

(805) 269-1585

NPI assigned

Apr 8, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Lauren Elvira Foster Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lauren.mirabdollah.1@17363.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Oceano, CA
  • NPI 1336166248
  Medicare reassignment
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • San Luis Obispo, CA
  • NPI 1275553257
  NPD
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Santa Maria, CA
  • NPI 1447277355
  NPD
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Templeton, CA
  • NPI 1851318638
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1003235904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8028",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CASA ST",
            "address_2": "SUITE 201-204",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055803",
            "telephone_number": "805-269-1500",
            "fax_number": "805-269-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRABDOLLAH",
        "first_name": "LAUREN",
        "middle_name": "ELVIRA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-08",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95000334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "FOSTER",
            "middle_name": "ELVIRA",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathleen Marie Milner
• Eric Alan Milo
• Youstina Mina
• Mindful Heart Family Therapy, Inc
• Jarred Dewayne Minefee, P.A.
• Miracle Ear
• Miracle-Ear, Inc.
• Geraldo Miramontes
• Daniel Boone Miranda
• Olga Mireles, RN

• Nurse Practitioner in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.