Carolyn Nmn Shively in San Luis Obispo - Licensed Psychiatric Technician

Carolyn Nmn Shively - NPI 1518025725

Carolyn Nmn Shively is a Licensed Psychiatric Technician in San Luis Obispo, California. Carolyn Nmn Shively practices all healthcare services and medical treatments related to Licensed Psychiatric Technician. The NPI Number for Carolyn Nmn Shively is 1518025725. The last update date is 2007-07-08.

Carolyn Nmn Shively's current location address is 2178 Johnson Ave, San Luis Obispo, California. You can contact this provider via phone number 8057814738 and fax number 8057811232. The mailing address for Carolyn Nmn Shively is 2178 Johnson Ave, San Luis Obispo, California. To know further, please read the information below!

Provider Profile Detail

Provider Name Carolyn Nmn Shively
Address 2178 Johnson Ave, San Luis Obispo, California
Phone Number 8057814738
Fax Number 8057811232
Sole Proprietor N
Credentials --

NPI Number Detail

NPI Number 1518025725
Provider Enumeration Date 2006-12-04
Last Updated Date 2007-07-08

Provider Mailing Address Detail

Address 2178 Johnson Ave
City San Luis Obispo
State California (CA)
Post Code 934014535
Phone Number 8057814738
Fax Number 8057811232

Provider's Primary Taxonomy Detail

Speciality Licensed Psychiatric Technician
Taxonomy 167G00000X
Licence No 13693
Definition:
An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psych

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FAQs about Carolyn Nmn Shively

What is the unique 10-digit identifier code issued to Carolyn Nmn Shively by the Centers for Medicare & Medicaid Services?

The Carolyn Nmn Shively has been assigned the NPI (National Provider Identifier) 1518025725 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.

Could you please share the complete physical location address where Carolyn Nmn Shively's facilities are situated?

The facilities of Carolyn Nmn Shively are physically located at the following address: 2178 Johnson Ave, San Luis Obispo, CA, 934014535.

What is the Carolyn Nmn Shively's specialty and taxonomy code?

The Carolyn Nmn Shively's specialty is Licensed Psychiatric Technician, and the corresponding taxonomy code is 167G00000X.

On what date did Carolyn Nmn Shively receive its 1518025725 assignment from the Centers for Medicare & Medicaid Services?

The Carolyn Nmn Shively was assigned its 1518025725 on 2006-12-04, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.

As of what date was the information regarding Carolyn Nmn Shively, such as address, specialty, and other details, last verified and confirmed to be up-to-date?

The information related to Carolyn Nmn Shively, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.

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