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2180 Johnson Ave San Luis Obispo CA 93401-4513 | |
| (805) 781-4700 | |
| (805) 781-1273 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2180 Johnson Ave, San Luis Obispo, California |
| Authorized Official Name and Position | Jeff Hamm (HEALTH AGENCY DIRECTOR) |
| Authorized Official Contact | 8057814700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2180 Johnson Ave San Luis Obispo CA 93401-4513 Ph: (805) 781-4700 | 2180 Johnson Ave San Luis Obispo CA 93401-4513 Ph: (805) 781-4700 |
| NPI Number | 1376754143 |
|---|---|
| Provider Enumeration Date | 05/24/2007 |
| Last Update Date | 12/27/2023 |
| Certification Date | 12/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376754143 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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