Individual provider Active NPI

Rena Eileen Powers

  • Licensed Psychiatric Technician
  • San Luis Obispo, CA
National Provider Identifier
1972008787
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
PT40735 Issued in CA
Practice address
2945 McMillan Ave Ste 240
San Luis Obispo, CA 93401-6771
Phone
(805) 439-4890
Fax
(805) 439-4891
NPI assigned
Mar 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Psychiatric Technician 167G00000X PT40735 CA Primary

Addresses

Primary practice location

2945 McMillan Ave Ste 240
San Luis Obispo, CA 93401-6771

Mailing address

2945 McMillan Ave Ste 240
San Luis Obispo, CA 93401-6771
Phone (805) 439-4890

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
PT40735CAMDLicensed Psychiatric Technician

NPI Registry JSON

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1972008787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 MCMILLAN AVE STE 240",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016771",
            "telephone_number": "805-439-4890",
            "fax_number": "805-439-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 MCMILLAN AVE STE 240",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016771",
            "telephone_number": "805-439-4890",
            "fax_number": "805-439-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS",
        "first_name": "RENA",
        "middle_name": "EILEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT40735",
            "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 Mar 26, 2018; 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.