Individual provider Active NPI

Jesse Delong, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Luis Obispo, CA
National Provider Identifier
1962942763
Registry record updated Apr 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95026438 Issued in CA
Practice address
1368 Marsh St
San Luis Obispo, CA 93401-3316
Phone
(805) 619-9915
Fax
(805) 540-7063
NPI assigned
Feb 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95026438 CA Primary

Addresses

Primary practice location

1368 Marsh St
San Luis Obispo, CA 93401-3316

Mailing address

1368 Marsh St
San Luis Obispo, CA 93401-3316

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
95026438CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Bauman Clinic CurrentSince Jan 4, 2026 Accepting new patients
Peakmind Mental Health & Performance Wellness, Professional Nursing Corporation Psychiatric/Mental Health PastSince Jan 4, 2026 Accepting new patients

Locations

1368 Marsh St
San Luis Obispo, CA 93401
Phone (805) 540-7060

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775865600000",
    "number": "1962942763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1368 MARSH ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1368 MARSH ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013316",
            "telephone_number": "805-619-9915",
            "fax_number": "805-540-7063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELONG",
        "first_name": "JESSE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-28",
        "last_updated": "2026-04-11",
        "certification_date": "2026-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95026438",
            "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 Apr 11, 2026; 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.