Active NPI
Alyn Bartick, MFT
- Specialist
- San Luis Obispo, CA
National Provider Identifier
1710368543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 12471
- Practice address
- 1411 Marsh St Ste 105
San Luis Obispo, CA 93401-2967 - Phone
- (805) 305-1392
- NPI assigned
- Jun 17, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 12471 | CA | Primary |
Addresses
Primary practice location
1411 Marsh St Ste 105
San Luis Obispo, CA 93401-2967
Mailing address
PO Box 13912
San Luis Obispo, CA 93406-3912
Phone (805) 305-1392
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: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Mar 11, 2024 through Mar 11, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12471 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434499200000",
"number": "1710368543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13912",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934063912",
"telephone_number": "805-305-1392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 MARSH ST STE 105",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012967",
"telephone_number": "805-305-1392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARTICK",
"first_name": "ALYN",
"name_prefix": "Ms.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-17",
"last_updated": "2015-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "12471",
"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 Jun 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.