NPIMap

Organization Active NPI

Coast Family Practice

  • Physician Assistant
  • Santa Maria, CA
National Provider Identifier
1902022890
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
COAST FAMILY PRACTICE
Practice address
607 Plaza Dr
Suite C201
Santa Maria, CA 93454-6944
Phone
(805) 928-3636
Fax
(805) 928-3608
NPI assigned
Apr 18, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Roxana Mata, P.A-C
Title
Physician Assistant
Phone
(805) 928-3636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

607 Plaza Dr
Suite C201
Santa Maria, CA 93454-6944

Mailing address

607 E. Plaza Drive
Suite C201
Santa Maria, CA 93454-6944
Phone (805) 928-3636

Other names 1

  • Andrew J. Henning Other name

National Provider Directory

National Provider Directory
Tax ID family
Andrew J Henning3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902022890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 E. PLAZA DRIVE",
            "address_2": "SUITE C201",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934546944",
            "telephone_number": "805-928-3636",
            "fax_number": "805-928-3608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 PLAZA DR",
            "address_2": "SUITE C201",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934546944",
            "telephone_number": "805-928-3636",
            "fax_number": "805-928-3608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATA",
        "authorized_official_first_name": "ROXANA",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "805-928-3636",
        "authorized_official_credential": "P.A-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andrew J. Henning",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.