San Luis Obispo Center for Change

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

SAN LUIS OBISPO CENTER FOR CHANGE

Practice address

285 South St
Suite M
San Luis Obispo, CA 93401-5037

Phone

(805) 544-2892

Fax

(805) 544-2887

NPI assigned

Nov 16, 2007

Last updated

Nov 16, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dave Davis

Title

Counselor

Phone

(805) 544-2892

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1861673964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SOUTH ST",
            "address_2": "SUITE M",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015037",
            "telephone_number": "805-544-2892",
            "fax_number": "805-544-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SOUTH ST",
            "address_2": "SUITE M",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015037",
            "telephone_number": "805-544-2892",
            "fax_number": "805-544-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN LUIS OBISPO CENTER FOR CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "805-544-2892",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6059",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• San Luis Obispo
• San Luis Obispo Behavioral Health
• San Luis Obispo Behavioral Health
• San Luis Obispo Ca Endoscopy ASC LP (Endoscopy Center of the Central Coast)
• San Luis Obispo Campus Health
• San Luis Obispo Child Development Center
• San Luis Obispo County
• San Luis Obispo County AIDS Support Network
• San Luis Obispo County Behavioral Health
• San Luis Obispo County CCS

• Addiction (Substance Use Disorder) Counselor in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.