Individual provider Active NPI

Harmeet Singh Brar, PSYCH TECH, RN

  • Registered Nurse
  • San Luis Obispo, CA
National Provider Identifier
1104984020
Registry record updated Sep 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
786001 Issued in CA
Practice address
2178 Johnson Ave
San Luis Obispo, CA 93401-4535
Phone
(805) 781-4711
Fax
(805) 781-4145
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 786001 CA Primary
Licensed Psychiatric Technician 167G00000X 24970 CA

Addresses

Primary practice location

2178 Johnson Ave
San Luis Obispo, CA 93401-4535

Mailing address

PO Box 21
Atascadero, CA 93423-0021
Phone (805) 462-7117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
786001CAMDRegistered Nurse
24970CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411862400000",
    "number": "1104984020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934230021",
            "telephone_number": "805-462-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2178 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014535",
            "telephone_number": "805-781-4711",
            "fax_number": "805-781-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAR",
        "first_name": "HARMEET",
        "middle_name": "SINGH",
        "name_prefix": "Mr.",
        "credential": "PSYCH TECH, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2014-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "786001",
            "primary": true
        },
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "24970",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.