Individual provider Active NPI

Jeannette Ann Palazuelos, RAMFT

  • Marriage & Family Therapist
  • San Luis Obispo, CA
National Provider Identifier
1508136474
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
125352 Issued in CA
Practice address
1255 Kendall Rd
San Luis Obispo, CA 93401-8750
Phone
(805) 781-3535
NPI assigned
Jan 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 125352 CA Primary

Addresses

Primary practice location

1255 Kendall Rd
San Luis Obispo, CA 93401-8750

Mailing address

1255 Kendall Rd
San Luis Obispo, CA 93401-8750

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
125352CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Network, Inc. Past Accepting new patients
Family Care Network, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1508136474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 KENDALL RD",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934018750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 KENDALL RD",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934018750",
            "telephone_number": "805-781-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAZUELOS",
        "first_name": "JEANNETTE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RAMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-09",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125352",
            "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 May 5, 2021; 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.