Individual provider Active NPI

Sofia Z Murillo

  • Clinical Psychologist
  • San Luis Obispo, CA
National Provider Identifier
1821117094
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
33308 Issued in CA
Practice address
Highway 1
San Luis Obispo, CA 93409-5149
Phone
(805) 547-7900
NPI assigned
Mar 28, 2007
Last updated
May 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Clinical Psychologist 103TC0700X 33308 CA Primary

Addresses

Primary practice location

Highway 1
San Luis Obispo, CA 93409-5149

Mailing address

804 Boysen Ave Apt 11
San Luis Obispo, CA 93405-1347
Phone (805) 637-0341

Other practice location 1

25 W Anapamu St Ste A
Santa Barbara, CA 93101-5149
Phone (805) 730-7575

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
33308CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Corrections and Rehabilitation-Headquarters CurrentSince May 8, 2022 Accepting new patients
Corrections and Rehabilitation-Headquarters CurrentSince May 8, 2022 Accepting new patients

Locations

Hwy 1
San Luis Obispo, CA 93409
Phone (805) 547-7857

Organizations & group practices 2

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1821117094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 BOYSEN AVE APT 11",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051347",
            "telephone_number": "805-637-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 1",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934095149",
            "telephone_number": "805-547-7900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 W Anapamu St Ste A",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931015149",
            "country_code": "US",
            "telephone_number": "805-730-7575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURILLO",
        "first_name": "SOFIA",
        "middle_name": "Z",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33308",
            "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 4, 2022; 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.