Individual provider Active NPI

Mary B Garrett, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Luis Obispo, CA
National Provider Identifier
1134499908
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
377062 Issued in CA
Practice address
1551 Bishop St
Suite a-150
San Luis Obispo, CA 93401-4693
Phone
(805) 541-6000
Fax
(805) 541-6001
NPI assigned
Jan 10, 2012
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 377062 CA Primary

Addresses

Primary practice location

1551 Bishop St
Suite a-150
San Luis Obispo, CA 93401-4693

Mailing address

1551 Bishop St
Suite a-150
San Luis Obispo, CA 93401-4693
Phone (805) 541-6000

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
377062CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Psychiatry Inc., a Professional Medical Corporation CurrentSince Apr 1, 2021 Accepting new patients

Locations

1551 Bishop St
Ste A150
San Luis Obispo, CA 93401
Phone (805) 235-5446

1304 Ella St
Ste B2
Sn Luis Obisp, CA 93401
Phone (805) 458-2232

Interoperability endpoints

  • Direct secure messaging: mary.garrett.1@23821.direct.athenahealth.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1134499908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 BISHOP ST",
            "address_2": "SUITE A-150",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014693",
            "telephone_number": "805-541-6000",
            "fax_number": "805-541-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 BISHOP ST",
            "address_2": "SUITE A-150",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014693",
            "telephone_number": "805-541-6000",
            "fax_number": "805-541-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "MARY",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "377062",
            "primary": true
        }
    ],
    "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 Apr 29, 2021; 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.