Individual provider Active NPI

Cassandra Lynn Williamson, RDHAP

  • Dental Hygienist
  • San Luis Obispo, CA
National Provider Identifier
1376236067
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
HAP989 Issued in CA
Practice address
1311 Fernwood Dr
San Luis Obispo, CA 93401-5910
Phone
(909) 693-0621
NPI assigned
May 30, 2023
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X HAP989 CA Primary

Addresses

Primary practice location

1311 Fernwood Dr
San Luis Obispo, CA 93401-5910

Mailing address

1311 Fernwood Dr
San Luis Obispo, CA 93401-5910
Phone (909) 693-0621

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

State licenses

LicenseStateTypeSpecialty
HAP989CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Cassandra Williamson Rdhap, Inc. Dental Hygienist CurrentSince Aug 13, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1376236067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 FERNWOOD DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015910",
            "telephone_number": "909-693-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 FERNWOOD DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015910",
            "telephone_number": "909-693-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "CASSANDRA",
        "middle_name": "LYNN",
        "credential": "RDHAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "HAP989",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 11, 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.

Verify at the official NPI Registry.