Active NPI
Terence Michael Dever
- Student in an Organized Health Care Education/Training Program
- San Luis Obispo, CA
National Provider Identifier
1255465464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 3765 S. Higuera
Suite 100
San Luis Obispo, CA 93401 - Phone
- (805) 781-3535
- Fax
- (805) 503-6499
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
3765 S. Higuera
Suite 100
San Luis Obispo, CA 93401
Mailing address
164 Lincoln St.
San Luis Obispo, CA 93405
Phone (805) 781-3535
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 390200000X | Other | TAXONOMY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411084800000",
"number": "1255465464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "164 LINCOLN ST.",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "93405",
"telephone_number": "805-781-3535",
"fax_number": "805-503-6499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3765 S. HIGUERA",
"address_2": "SUITE 100",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "93401",
"telephone_number": "805-781-3535",
"fax_number": "805-503-6499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVER",
"first_name": "TERENCE",
"middle_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2014-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAXONOMY",
"identifier": "390200000X",
"state": null
}
],
"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 19, 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.