Active NPI
Rose Ann Drago, MD
- Psychiatry Physician
- San Luis Obispo, CA
National Provider Identifier
1306904982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G63784
- Practice address
- 2178 Johnson Ave
San Luis Obispo, CA 93401-4535 - Phone
- (805) 781-4700
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G63784 | CA | Primary |
Addresses
Primary practice location
2178 Johnson Ave
San Luis Obispo, CA 93401-4535
Mailing address
2178 Johnson Ave
San Luis Obispo, CA 93401-4535
Phone (805) 781-4700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G63784 | Other | CA | MEDICAL LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63784 | CA | MD | Dentist Anesthesiologist |
| G63784 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1306904982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2178 JOHNSON AVE",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934014535",
"telephone_number": "805-781-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2178 JOHNSON AVE",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934014535",
"telephone_number": "805-781-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAGO",
"first_name": "ROSE",
"middle_name": "ANN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G63784",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "G63784",
"state": "CA"
}
],
"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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.