California Polytechnic State University at San Luis Obispo

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

RN 358948 Issued in CA

Legal business name

CALIFORNIA POLYTECHNIC STATE UNIVERSITY AT SAN LUIS OBISPO

Practice address

Cal Poly Health Services
Grand Ave.
San Luis Obispo, CA 93407

Phone

(805) 756-1211

Fax

(805) 756-5298

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Carol A. Freeman, FNP

Title

Nurse Practitioner

Phone

(805) 756-1211

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219622400000",
    "number": "1750442653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CAL POLY STATE UNIVERSITY HEALTH SERVICES",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93407",
            "telephone_number": "805-756-1211",
            "fax_number": "805-745-5298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CAL POLY HEALTH SERVICES",
            "address_2": "GRAND AVE.",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93407",
            "telephone_number": "805-756-1211",
            "fax_number": "805-756-5298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA POLYTECHNIC STATE UNIVERSITY AT SAN LUIS OBISPO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-08-25",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "805-756-1211",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "RN 358948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• California Medical Surgery Center LLC
• California Men'S Colony Hospital
• California Neurohealth
• California Polytechnic State University
• California Polytechnic State University at San Luis Obispo
• California Retina Consultants
• California Wellness Center
• Katie Callahan
• Chandra Calloway
• Enrique Camacho Jr., D.O.

• Clinic/Center in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; 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.