NPIMap

Organization Active NPI

Sun Street Centers

  • Substance Abuse Rehabilitation Facility
  • San Luis Obispo, CA
National Provider Identifier
1346991973
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SUN STREET CENTERS
Practice address
34 Prado Road
San Luis Obispo, CA 93401
Phone
(831) 753-5135
Fax
(831) 753-5163
NPI assigned
Jan 14, 2022
Organization subpart
Yes
Parent organization
SUN STREET CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Authorized official

Name
Gordon William Horne, LAADC
Title
Clinical Supervisor
Phone
(831) 809-8176

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

34 Prado Road
San Luis Obispo, CA 93401

Mailing address

34 Prado Road
San Luis Obispo, CA 93401
Phone (831) 809-8176

Other names 1

  • Sun Street Centers Other name

National Provider Directory

National Provider Directory
Tax ID family
Sun Street Centers13 organizations share this tax ID, including this one
Part of
Sun Street Centers

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

34 Prado Rd
San Luis Obispo, CA 93401
Phone (805) 457-3331

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

  • Yuri Caballero
    • Addiction (Substance Use Disorder) Counselor
    • San Luis Obispo, CA
    • NPI 1366155814
    NPD
  • Ethan J Gonsalves, RADT
    • Addiction (Substance Use Disorder) Counselor
    • San Luis Obispo, CA
    • NPI 1053035402
    NPD
  • Amanda Torrente
    • Addiction (Substance Use Disorder) Counselor
    • San Luis Obispo, CA
    • NPI 1043624521
    NPD

NPI Registry JSON

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1346991973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 PRADO ROAD",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93401",
            "telephone_number": "831-809-8176",
            "fax_number": "831-753-5163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PRADO ROAD",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93401",
            "telephone_number": "831-753-5135",
            "fax_number": "831-753-5163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN STREET CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUN STREET CENTERS",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "HORNE",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "831-809-8176",
        "authorized_official_credential": "LAADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sun Street Centers",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Sun Street Centers",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Feb 25, 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.