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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY 17917 | CA | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144318072 | Jeffrey Craig Elliott | Dentist | 301 College Avenue, Santa Rosa, CA 95405 | 2006-10-10 |
1740810001 | Jeffrey Scott Elliott | Student in an Organized Health Care Education/Training Program | 616 North St, Portsmouth, VA 23704-2415 | 2020-01-24 |
1770120438 | Jeffrey Elliott | Occupational Therapist | 9768 Liberty Dr, Painted Post, NY 14870-9094 | 2019-12-02 |
1780080887 | Jeffrey Elliott | Specialist/Technologist | 1150 Campo Sano Ave, Suite 200, Coral Gables, FL 33146-1174 | 2014-11-17 |
1649460312 | Jeffrey Bryan Elliott | Counselor | 4824 E Baseline Rd, Suite 124, Mesa, AZ 85206-4676 | 2007-07-30 |
1558305102 | Jeffrey Lance Elliott | Anesthesiology | 516 E. Nizhoni Blvd., Gallup, NM 87301-1337 | 2006-06-15 |
1487607214 | Jeffrey Leigh Elliott | Psychiatry & Neurology | 5323 Harry Hines Blvd, Dallas, TX 75390-7208 | 2006-05-19 |
1639138795 | Jeffrey M Elliott | Internal Medicine | 1901 Melba Dr, Dothan, AL 36301-3017 | 2006-03-18 |
Street Address |
2178 JOHNSON AVE |
City | SAN LUIS OBISPO |
State | CA |
Zip Code | 93401-4535 |
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 |
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 | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
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 |
Find all providers in SAN LUIS OBISPO |
City | SAN LUIS OBISPO |
Zip Code | 93401 |
Please comment or provide details below to improve the information on DR. JEFFREY BRUCE ELLIOTT.
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.