Cabrillo Care Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CABRILLO CARE CENTER

Practice address

3033 Augusta St
San Luis Obispo, CA 93401-5820

Phone

(805) 544-5100

Fax

(805) 544-7209

NPI assigned

May 31, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bryan Roldan

Title

Administrator

Phone

(805) 544-5100

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659374981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 AUGUSTA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015820",
            "telephone_number": "805-544-5100",
            "fax_number": "805-544-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 AUGUSTA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015820",
            "telephone_number": "805-544-5100",
            "fax_number": "805-544-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CABRILLO CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROLDAN",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "805-544-5100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT06189H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Joan Cabanas
• Ana Cabezas, PSY.D.
• Haley Kathleen Cabral
• Kirstie Cabral
• Juan Jose Cabrera
• Claudia J Cadwallader, L.AC.
• Emma Perry Cadwallader, RPT
• Patrick Michael Cady, R.N.
• Nicholas Manes Caggiano, MD
• Scott William Cahill I

• Skilled Nursing Facility in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.