Individual provider Active NPI

Mikaela Renee Cohen, PA-C

  • Physician Assistant
  • San Luis Obispo, CA
National Provider Identifier
1245895564
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
56601 Issued in CA
Practice address
777 E Foothill Blvd
San Luis Obispo, CA 93405-1617
Phone
(805) 762-4348
Fax
(805) 541-1167
NPI assigned
May 2, 2019
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 56601 CA Primary

Addresses

Primary practice location

777 E Foothill Blvd
San Luis Obispo, CA 93405-1617

Mailing address

PO Box 689
Santa Barbara, CA 93102-0689
Phone (805) 762-4348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190606000296 CA Practitioner - Physician Assistant 5799018784 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cottage Clinical Network LLCGroup PAC ID 1850712530, 57 clinicians

Practice addresses (Care Compare)

777 E Foothill Blvd
San Luis Obispo, CA 93405-1617
Phone (805) 762-4348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc CurrentSince May 20, 2019 Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince May 20, 2019 Accepting new patients
Community Health Centers of the Central Coast Inc Past Accepting new patients
Cottage Medical Associates Past Accepting new patients

Locations

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

1551 Bishop St
Ste A160
Sn Luis Obisp, CA 93401
Phone (805) 781-4230

325 Posada Ln
Templeton, CA 93465
Phone (805) 239-0644

Organizations & group practices 8

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": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1245895564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931020689",
            "telephone_number": "805-762-4348",
            "fax_number": "805-541-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E FOOTHILL BLVD",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051617",
            "telephone_number": "805-762-4348",
            "fax_number": "805-541-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "MIKAELA",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-02",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.