DR. JEFFREY BRUCE ELLIOTT


Address: 2178 Johnson Ave, San Luis Obispo, CA 93401-4535
Phone: 8057815525

DR. JEFFREY BRUCE ELLIOTT (NPI# 1114919263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114919263
Entity Type Individual
Full Name DR. JEFFREY BRUCE ELLIOTT
Credential PSYD
Practice Address 2178 Johnson Ave
San Luis Obispo
CA 93401-4535
Mailing Address Po Box 425
Santa Maria
CA 93456-0425
Practice Telephone 8057815525
Practice Fax Number 8057811232
Mailing Telephone 8059345900
Enumeration Date 2005-08-16
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
PSY 17917 CA Behavioral Health & Social Service Providers

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Office Location

Street Address 2178 JOHNSON AVE
City SAN LUIS OBISPO
State CA
Zip Code 93401-4535

Providers in the same location

NPI Name Taxonomy Address Enumeration
1548860745 Colleen Noel Margalit Registered Nurse 2178 Johnson Ave, San Luis Obispo, CA 93401-4535 2020-10-27
1245839133 Eliruth Ortiz Licensed Vocational Nurse 2178 Johnson Ave, San Luis Obispo, CA 93401-4535 2020-10-21
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
1053935718 Sharon Beryl Maslow Registered Nurse 2178 Johnson Ave, San Luis Obispo, CA 93401-4535 2020-05-28
1629691357 Bryan A Smith Registered Nurse 2178 Johnson Ave, San Luis Obispo, CA 93401-4535 2020-05-28
1093338196 Karen Jennifer Greene Registered Nurse 2178 Johnson Ave, San Luis Obispo, CA 93401-4535 2020-05-22
1902434053 Mehta Halstead Registered Nurse 2178 Johnson Ave, San Luis Obispo, CA 93401-4535 2020-04-01
1447884010 Casey Lynn Kay Licensed Vocational Nurse 2178 Johnson Ave, San Luis Obispo, CA 93401-4535 2020-02-23
1689207474 Valerie Holtz Counselor 2178 Johnson Ave, San Luis Obispo, CA 93401-4535 2020-02-19
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689291007 Kerianne Elizabeth Ditomasso Psychologist 1551 Bishop St Ste A-130, San Luis Obispo, CA 93401-4635 2020-07-01
1366949943 Lisa Slover Psychologist 1530 Monterey St Ste A, San Luis Obispo, CA 93401-2969 2018-04-10
1376991315 Karin Kerstin Gutierrez Psychologist 1107 Johnson Avenue, San Luis Obispo, CA 93401 2016-06-01
1225411614 Stephen Theodore Bobey Jr. Psychologist 1129 Marsh St, San Luis Obispo, CA 93401-3323 2015-07-02
1760884670 Robert Ryan Psychologist 1 Hwy 1, San Luis Obispo, CA 93409-8101 2014-09-23
1194135772 Sarah Chisholm Psychologist California Mens Colony Highway 1 N, Dq Mental Health Building, San Luis Obispo, CA 93409-8101 2014-05-05
1699198689 Cynthia Mccabe Psychologist California Mens Colony Mental Health, Hwy 1 North, Box 8101, San Luis Obispo, CA 93409-8101 2014-01-27
1164854139 James Brian Fishback Psychologist 4421 Brookpine Dr, San Luis Obispo, CA 93401-7802 2013-08-01
1184967226 Deserie R Barragan Psychologist D Facility Highway 1, Department of Corrections and Rehabilitation, San Luis Obispo, CA 93403 2013-03-27
1811234297 Barbara Y Mair Psychologist Hwy 1 N, San Luis Obispo, CA 93409-0001 2013-01-06
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Competitor

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City SAN LUIS OBISPO
Zip Code 93401

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Dataset Information

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.

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