Individual provider Active NPI

Cheryl K Delos Reyes, FNP-C

  • Family Nurse Practitioner
  • San Luis Obispo, CA
National Provider Identifier
1487411930
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95028790 Issued in CA
Practice address
10 Santa Rosa St
San Luis Obispo, CA 93405-5826
Phone
(805) 544-7246
NPI assigned
Mar 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95028790 CA Primary

Addresses

Primary practice location

10 Santa Rosa St
San Luis Obispo, CA 93405-5826

Mailing address

5590 Chauplin Ave
Atascadero, CA 93422-3106
Phone (661) 345-8822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95028790CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Coast Pain Management Specialists, Inc. CurrentSince Sep 29, 2024 Accepting new patients

Locations

10 Santa Rosa St
San Luis Obispo, CA 93405
Phone (805) 461-9192

10 Santa Rosa St
Unit 201
San Luis Obispo, CA 93405
Phone (805) 544-7246

10 Santa Rosa St
Ste 201
Sn Luis Obisp, CA 93405
Phone (805) 544-7246

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1487411930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5590 CHAUPLIN AVE",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934223106",
            "telephone_number": "661-345-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SANTA ROSA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055826",
            "telephone_number": "805-544-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELOS REYES",
        "first_name": "CHERYL",
        "middle_name": "K",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.