JACOB ADAM ZAVALA (NPI# 1114554227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114554227 |
| Entity Type | Individual |
| Full Name | JACOB ADAM ZAVALA |
| Practice Address |
2945 Mcmillan Ave Ste 240 San Luis Obispo CA 93401-6771 |
| Mailing Address |
1153 Ash St Ste B Arroyo Grande CA 93420-3844 |
| Practice Telephone | 8054394890 |
| Mailing Telephone | 8054583659 |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-05-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | 41575 | CA | Nursing Service Providers |
| Street Address |
2945 MCMILLAN AVE STE 240 |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93401-6771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417016247 | Damon Joseph Maggiore | Marriage & Family Therapist | 2945 Mcmillan Ave Ste 240, San Luis Obispo, CA 93401 | 2006-12-07 |
| 1740888494 | Danielle Voegele | Nursing Facility/Intermediate Care Facility | 2945 Mcmillan Ave Ste 240, San Luis Obispo, CA 93401-6771 | 2020-10-14 |
| 1295340156 | Gregory Garrow | Social Worker | 2945 Mcmillan Ave Ste 240, San Luis Obispo, CA 93401-6771 | 2020-09-08 |
| 1598379497 | Jennifer Marie Lopez | Licensed Vocational Nurse | 2945 Mcmillan Ave Ste 240, San Luis Obispo, CA 93401-6771 | 2020-09-08 |
| 1386268373 | Sierra L Shalhoub | Technician, Other | 2945 Mcmillan Ave Ste 240, San Luis Obispo, CA 93401-6771 | 2020-06-04 |
| 1114552502 | Brooke Klever | Counselor | 2945 Mcmillan Ave Ste 240, San Luis Obispo, CA 93401-6771 | 2020-03-06 |
| 1760028336 | Eric Randall Storey | Technician, Health Information | 2945 Mcmillan Ave Ste 240, San Luis Obispo, CA 93401-6771 | 2019-11-19 |
| 1679119267 | Samuel Joseph Ray | Licensed Vocational Nurse | 2945 Mcmillan Ave Ste 240, San Luis Obispo, CA 93401-6771 | 2019-11-19 |
| 1235798182 | Tessa Ann Pereira | Licensed Psychiatric Technician | 2945 Mcmillan Ave Ste 240, San Luis Obispo, CA 93401-6771 | 2019-06-12 |
| 1871055293 | Hekmat Casados | Licensed Vocational Nurse | 2945 Mcmillan Ave Ste 240, San Luis Obispo, CA 93401-6771 | 2019-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497228399 | Barbara Jean Morrow | Dental Hygienist | 2191 Johnson Avenue, San Luis Obispo, CA 93401 | 2019-01-03 |
| 1104307743 | Griffith Jennings | Counselor | 1225 Kendal Rd, San Luis Obispo, CA 93401 | 2018-08-22 |
| 1124518808 | Joy L Delaluna | Licensed Psychiatric Technician | 692 Evens Rd, San Luis Obispo, CA 93401 | 2018-05-17 |
| 1982192084 | Sierra Mental Wellness Group | Community/Behavioral Health | 2180 B Johnson Avenue, San Luis Obispo, CA 93401 | 2018-04-25 |
| 1326554403 | Veronica Chanel Laguna | Case Manager/Care Coordinator | 1065 Kansas Ave., San Luis Obispo, CA 93401 | 2017-12-27 |
| 1043739782 | Janette Lynn Branca | Case Manager/Care Coordinator | 285 South Street, Suit J, San Louis Obispo, CA 93401 | 2017-09-13 |
| 1588194104 | Adv Vision LLC | Optometrist | 835 Aero Vista Pl, #110, San Luis Obispo, CA 93401 | 2017-06-15 |
| 1508395880 | Samantha Clay | Counselor | 1255 Kendall Road, San Luis Obispo, CA 93401 | 2017-06-08 |
| 1659804771 | Sara Anne Powers | Counselor | 697 Higuera Street D, San Luis Obispo, CA 93401 | 2017-04-05 |
| 1508306010 | Russell Piazza | Pharmacist | 873 Ricardo Court, San Luis Obispo, CA 93401 | 2017-03-02 |
| Find all providers in zip 93401 | ||||
| Taxonomy Code | 167G00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Psychiatric Technician |
| 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 psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124518808 | Joy L Delaluna | Licensed Psychiatric Technician | 692 Evens Rd, San Luis Obispo, CA 93401 | 2018-05-17 |
| 1770098154 | Alpha Barrie | Licensed Psychiatric Technician | 1050 E Foothill Blvd, San Luis Obispo, CA 93405-1860 | 2017-12-07 |
| 1891025607 | Holly Lindenthaler | Licensed Psychiatric Technician | 1012 Vista Del Collados, San Luis Obispo, CA 93405-4822 | 2009-12-30 |
| 1457546673 | Brian Rick Atwell Sr. | Licensed Psychiatric Technician | 2178 Johnson Ave # Phf, San Luis Obispo, CA 93401-4535 | 2007-09-11 |
| 1659415156 | Jana Kathlin Cearley | Licensed Psychiatric Technician | 1585 Kansas Ave, San Luis Obispo, CA 93405-7604 | 2007-02-16 |
| 1689714628 | Heidi Sarmento | Licensed Psychiatric Technician | 1585 Kansas Ave., San Luis Obispo, CA 93401 | 2007-02-07 |
| 1578181996 | Lynnette Warren | Licensed Psychiatric Technician | 2178 Johnson Ave, San Luis Obispo, CA 93401-4535 | 2020-07-13 |
| 1184242869 | Kevin Nitzel | Licensed Psychiatric Technician | 2178 Johnson Ave, San Luis Obispo, CA 93401-4535 | 2020-07-09 |
| 1003452285 | Jennifer N Kuiken | Licensed Psychiatric Technician | 2178 Johnson Ave, San Luis Obispo, CA 93401-4535 | 2019-11-21 |
| 1902441405 | Michael O'toole | Licensed Psychiatric Technician | 2178 Johnson Ave, San Luis Obispo, CA 93401-4535 | 2019-11-08 |
| Find all providers in SAN LUIS OBISPO | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.