Individual provider Active NPI

Jessie Shorts

  • Student in an Organized Health Care Education/Training Program
  • San Luis Obispo, CA
National Provider Identifier
1689064453
Registry record updated Sep 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1255 Kendall Rd
San Luis Obispo, CA 93401-8750
Phone
(805) 781-3535
NPI assigned
Jan 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1255 Kendall Rd
San Luis Obispo, CA 93401-8750

Mailing address

742 Boysen Ave Apt 6
San Luis Obispo, CA 93405-1342
Phone (949) 933-8970

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

NPI Registry JSON

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

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1689064453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 BOYSEN AVE APT 6",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051342",
            "telephone_number": "949-933-8970"
        },
        {
            "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": "SHORTS",
        "first_name": "JESSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-30",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "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 15, 2017; 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.