Pacific Psychiatry Inc.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C2754748 Issued in CA

Legal business name

PACIFIC PSYCHIATRY INC.

Practice address

3220 S Higuera St
Suite 215
San Luis Obispo, CA 93401-6987

Phone

(805) 541-5055

Fax

(805) 541-5075

NPI assigned

Aug 24, 2007

Organization subpart

No

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

Authorized official

Name

John Michael Rivard, M.D.

Title

President

Phone

(805) 541-5055

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23821/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187913600000",
    "number": "1164615910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 S HIGUERA ST",
            "address_2": "SUITE 215",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016987",
            "telephone_number": "805-541-5055",
            "fax_number": "805-541-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 S HIGUERA ST",
            "address_2": "SUITE 215",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016987",
            "telephone_number": "805-541-5055",
            "fax_number": "805-541-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC PSYCHIATRY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "last_updated": "2007-08-24",
        "status": "A",
        "authorized_official_last_name": "RIVARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-541-5055",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C2754748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORP RESGISTRATION #",
            "identifier": "C2754748",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FICITITOUS NAME PERMIT",
            "identifier": "FNP33987",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Coast Physicians Medical Group
• Pacific Eye Surgeons, a California Professional Medical Corporation
• Pacific Medical, Inc.
• Pacific Pediatric Dentistry
• Pacific Point Laboratories, Inc.
• Pacific Psychiatry Inc., a Professional Medical Corporation
• Pacific Surgery Center of San Luis Obispo, LLC
• Pacifica Slo LLC
• Grace Marie Padden
• Shasta Mae J Padernal, LVN

• Psychiatry Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; 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.