Individual provider Active NPI

Chris Eaton, MFT INTERN

  • Marriage & Family Therapist
  • San Luis Obispo, CA
National Provider Identifier
1730396169
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF 51388 Issued in CA
Practice address
2945 McMillan Ave
Suite 136
San Luis Obispo, CA 93401-6766
Phone
(805) 781-4757
Fax
(805) 781-1267
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF 51388 CA Primary

Addresses

Primary practice location

2945 McMillan Ave
Suite 136
San Luis Obispo, CA 93401-6766

Mailing address

2945 McMillan Ave
Suite 136
San Luis Obispo, CA 93401-6766
Phone (805) 781-4757

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
IMF 51388CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730396169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 MCMILLAN AVE",
            "address_2": "SUITE 136",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016766",
            "telephone_number": "805-781-4757",
            "fax_number": "805-781-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 MCMILLAN AVE",
            "address_2": "SUITE 136",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016766",
            "telephone_number": "805-781-4757",
            "fax_number": "805-781-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "CHRIS",
        "credential": "MFT INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 51388",
            "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 Jul 8, 2007; 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.