Individual provider Active NPI

Jennifer Lynn Cross

  • Registered Nurse
  • San Luis Obispo, CA
National Provider Identifier
1740773480
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
776063 Issued in CA
Practice address
784 High St
San Luis Obispo, CA 93401-5243
Phone
(805) 858-0945
Fax
(805) 221-6352
NPI assigned
Jun 7, 2018
Last updated
Feb 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 776063 CA Primary

Addresses

Primary practice location

784 High St
San Luis Obispo, CA 93401-5243

Mailing address

784 High St
San Luis Obispo, CA 93401-5243
Phone (805) 858-0945

Other identifiers 1

IdentifierTypeStateIssuer
1528150711OtherCAOUTPATIENT EATING DISORDER TREATMENT PROGRAM

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
776063CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Central Coast Outpatient Program Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1740773480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 HIGH ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015243",
            "telephone_number": "805-858-0945",
            "fax_number": "805-221-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 HIGH ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015243",
            "telephone_number": "805-858-0945",
            "fax_number": "805-221-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSS",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "776063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUTPATIENT EATING DISORDER TREATMENT PROGRAM",
            "identifier": "1528150711",
            "state": "CA"
        }
    ],
    "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 Feb 20, 2026; 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.