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458 Higuera St San Luis Obispo CA 93401-3833 | |
| (805) 544-2678 | |
| (805) 544-2566 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 458 Higuera St, San Luis Obispo, California |
| Authorized Official Name and Position | Jill Bolster-white (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8055415144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 15408 San Luis Obispo CA 93406-5408 Ph: (805) 541-5144 | 458 Higuera St San Luis Obispo CA 93401-3833 Ph: (805) 544-2678 |
| NPI Number | 1548442718 |
|---|---|
| Provider Enumeration Date | 11/29/2007 |
| Last Update Date | 07/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548442718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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