Individual provider Active NPI

Jourdan Mackenzie Muro, PA-C

  • Physician Assistant
  • San Luis Obispo, CA
National Provider Identifier
1750151601
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA67197 Issued in CA
Practice address
4460 Broad St Ste 110
San Luis Obispo, CA 93401-8065
Phone
(805) 597-6715
Fax
(805) 541-4973
NPI assigned
Jan 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA67197 CA Primary

Addresses

Primary practice location

4460 Broad St Ste 110
San Luis Obispo, CA 93401-8065

Mailing address

4460 Broad St Ste 110
San Luis Obispo, CA 93401-8065
Phone (805) 597-6715

Other practice location 1

2 James Way Ste 209
Pismo Beach, CA 93449-4976
Phone (805) 549-6915

Other practice location 2

2 James Way Ste 106
Pismo Beach, CA 93449-4974
Phone (805) 473-7665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251223002530 CA Practitioner - Physician Assistant 1153816566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Central Coast Health CentersGroup PAC ID 9739091364, 247 clinicians

Practice addresses (Care Compare)

4460 Broad St
Suite 110
San Luis Obispo, CA 93401-8065
Phone (805) 597-6715

Hospital & facility affiliations

  • French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232
  • Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
67197CAMDSocial Worker
PA67197CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers CurrentSince Dec 10, 2025 Accepting new patients
Pacific Central Coast Health Centers CurrentSince Dec 10, 2025 Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

500 Old River Rd
Ste 200
Bakersfield, CA 93311
Phone (661) 663-6429

2901 N Ventura Rd
Ste 110
Oxnard, CA 93036
Phone (805) 981-6163

2 James Way
Ste 106
Pismo Beach, CA 93449
Phone (805) 473-7665

2 James Way
Ste 209
Pismo Beach, CA 93449
Phone (805) 549-6915

4460 Broad St
Ste 110
San Luis Obispo, CA 93401
Phone (805) 597-6715

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

Organizations & group practices 4

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1750151601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 BROAD ST STE 110",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934018065",
            "telephone_number": "805-597-6715",
            "fax_number": "805-541-4973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 BROAD ST STE 110",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934018065",
            "telephone_number": "805-597-6715",
            "fax_number": "805-541-4973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 James Way Ste 209",
            "address_purpose": "LOCATION",
            "city": "Pismo Beach",
            "state": "CA",
            "postal_code": "934494976",
            "country_code": "US",
            "telephone_number": "805-549-6915",
            "fax_number": "805-549-6916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 James Way Ste 106",
            "address_purpose": "LOCATION",
            "city": "Pismo Beach",
            "state": "CA",
            "postal_code": "934494974",
            "country_code": "US",
            "telephone_number": "805-473-7665",
            "fax_number": "805-473-7666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURO",
        "first_name": "JOURDAN",
        "middle_name": "MACKENZIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-02",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA67197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.