Brandon Tyler Ginkel

Key facts

NPI

1043915432

Entity type

Individual (NPI type 1)

Primary specialty

Rehabilitation Practitioner 225400000X

Practice address

784 High St
San Luis Obispo, CA 93401-5243

Phone

(805) 540-6500

Fax

(805) 540-6501

NPI assigned

Apr 4, 2023

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 5, 2025.

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1043915432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15408",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934065408",
            "telephone_number": "805-540-6500",
            "fax_number": "805-540-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 HIGH ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015243",
            "telephone_number": "805-540-6500",
            "fax_number": "805-540-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINKEL",
        "first_name": "BRANDON",
        "middle_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-04",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-OPLQSC",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dick Gin, ATC
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• Jalani M Giove
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• Erol Giray
• Claire Girolo, LMFT
• Garrett Girvan

All providers in San Luis Obispo, CA · Rehabilitation Practitioner in California