Individual provider Active NPI

Michelle Marie Missler, MA/PPS

  • School Psychologist
  • San Luis Obispo, CA
National Provider Identifier
1770374035
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
210176088 Issued in CA
Practice address
1500 Lizzie St
San Luis Obispo, CA 93401-3062
Phone
(805) 549-1200
NPI assigned
May 15, 2025
Last updated
May 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 210176088 CA Primary

Addresses

Primary practice location

1500 Lizzie St
San Luis Obispo, CA 93401-3062

Mailing address

1500 Lizzie St
San Luis Obispo, CA 93401-3062
Phone (805) 549-1200

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
210176088CAMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1770374035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LIZZIE ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013062",
            "telephone_number": "805-549-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LIZZIE ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013062",
            "telephone_number": "805-549-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSLER",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "MA/PPS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "210176088",
            "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 May 15, 2025; 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.