Individual provider Active NPI

Monique Crystal Gilmore

  • Student in an Organized Health Care Education/Training Program
  • Arroyo Grande, CA
National Provider Identifier
1194557306
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
227 S Halcyon Rd Ste 101
Arroyo Grande, CA 93420-3174
Phone
(805) 801-2231
NPI assigned
Aug 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

227 S Halcyon Rd Ste 101
Arroyo Grande, CA 93420-3174

Mailing address

1172 E Grand Ave
Arroyo Grande, CA 93420-2556
Phone (805) 801-2231

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Youth Coalition CurrentSince Nov 17, 2024 Accepting new patients
Central Coast Psychological Services Corporation CurrentSince Aug 18, 2024 Accepting new patients

Locations

1172 E Grand Ave
Arroyo Grande, CA 93420
Phone (805) 210-0472

152 W Branch St
Ste A
Arroyo Grande, CA 93420
Phone (805) 801-2231

227 S Halcyon Rd
Ste 101
Arroyo Grande, CA 93420
Phone (805) 801-2231

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1194557306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1172 E GRAND AVE",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934202556",
            "telephone_number": "805-801-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 S HALCYON RD STE 101",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934203174",
            "telephone_number": "805-801-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "MONIQUE",
        "middle_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arroyo Grande, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.