Daniel Boone Miranda

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

36369 Issued in CA

Practice address

1989 Vicente Dr
San Luis Obispo, CA 93405-6863

Phone

(805) 781-4179

NPI assigned

May 29, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• County of San Luis Obispo

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arroyo Grande, CA
  • NPI 1932563053
  NPD (past)

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1285994939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1989 VICENTE DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934056863",
            "telephone_number": "805-781-4179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1989 VICENTE DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934056863",
            "telephone_number": "805-781-4179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2178 Johnson Ave",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934014535",
            "country_code": "US",
            "telephone_number": "805-781-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "DANIEL",
        "middle_name": "BOONE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-29",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PT 36369",
            "primary": false
        },
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "36369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jarred Dewayne Minefee, P.A.
• Lauren Elvira Mirabdollah, N.P.
• Miracle Ear
• Miracle-Ear, Inc.
• Geraldo Miramontes
• Olga Mireles, RN
• Ashley Rae Mishra, FNP-C
• Michelle Marie Missler, MA/PPS
• Carol L Misson, MA RN
• Robert Tom Misson, M.D.

• Licensed Psychiatric Technician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Licensed Psychiatric Technician in California

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