Individual provider Active NPI

Alexandra S Santos, NP-F

  • Obstetrics & Gynecology Nurse Practitioner
  • San Luis Obispo, CA
National Provider Identifier
1770726010
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
11675 Issued in CA
Practice address
184 Casa St
San Luis Obispo, CA 93405-1804
Phone
(805) 544-4883
Fax
(805) 542-0827
NPI assigned
Apr 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 11675 CA Primary

Addresses

Primary practice location

184 Casa St
San Luis Obispo, CA 93405-1804

Mailing address

184 Casa St
San Luis Obispo, CA 93405-1804
Phone (805) 544-4883

Other identifiers 4

IdentifierTypeStateIssuer
11675OtherCADCA BOARD OF REGISTERED NURSING - NURSE PRACTITIONER LICENSE
12160020OtherCACAQH PROVIDER NUMBER
0350605OtherCAANCC
553799OtherCADCA BOARD OF REGISTERED NURSING LICENSE NUMBER

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11675CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1770726010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 CASA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051804",
            "telephone_number": "805-544-4883",
            "fax_number": "805-542-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 CASA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051804",
            "telephone_number": "805-544-4883",
            "fax_number": "805-542-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "ALEXANDRA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "NP-F",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-16",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "11675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DCA BOARD OF REGISTERED NURSING - NURSE PRACTITIONER LICENSE",
            "identifier": "11675",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER NUMBER",
            "identifier": "12160020",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "0350605",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DCA BOARD OF REGISTERED NURSING LICENSE NUMBER",
            "identifier": "553799",
            "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 Sep 7, 2011; 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.