Mariah Sibal, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34744-TLG Issued in CA

Practice address

11990 Los Osos Valley Rd
San Luis Obispo, CA 93405-6861

Phone

(805) 858-9914

Fax

(805) 316-4113

NPI assigned

Dec 21, 2020

Sex

Female

Sole proprietor

No

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

Locations

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.

• Sibal Optometry, Inc.

  • Optometrist
  • San Luis Obispo, CA
  • NPI 1508451345
  NPD Authorized official

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1295322576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11990 LOS OSOS VALLEY RD",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934056861",
            "telephone_number": "805-858-9914",
            "fax_number": "805-316-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11990 LOS OSOS VALLEY RD",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934056861",
            "telephone_number": "805-858-9914",
            "fax_number": "805-316-4113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2495 Iron Point Rd",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956308710",
            "country_code": "US",
            "telephone_number": "916-817-8965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIBAL",
        "first_name": "MARIAH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-21",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34744",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34744-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie Shorts
• Amanda Shrewsbury
• Ryan Davin Shurson, LMFT
• Faris Shweikeh, M.D.
• Sibal Optometry, Inc.
• Alex Sicaud
• John Barry Siebenlist, M.D.
• Lawrence Zachary Siegler, MFT
• Sierra Mental Wellness
• Sierra Mental Wellness Group

• Optometrist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.