MARY M OKIMOTO (NPI# 1144400771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144400771 |
Entity Type | Individual |
Full Name | MARY M OKIMOTO |
Credential | NP |
Practice Address |
715 Tank Farm Road Suite C San Luis Obispo CA 93401-7068 |
Mailing Address |
117 West Bunny Avenue Santa Maria CA 93458-2805 |
Practice Telephone | 8055435577 |
Practice Fax Number | 8055953231 |
Mailing Telephone | 8055435577 |
Mailing Fax Number | 8055953231 |
Enumeration Date | 2007-11-12 |
Last Update Date | 2015-12-26 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 364SX0204X |
Clinical Nurse Specialist Specialization: Oncology, Pediatrics |
17444 | CA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | MEDICARE ID | CB242811 | 01 |
Street Address |
715 TANK FARM ROAD SUITE C |
City | SAN LUIS OBISPO |
State | CA |
Zip Code | 93401-7068 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750385183 | Oncology Hematology Medical Associates of The Central Coast | Internal Medicine | 715 Tank Farm Road, San Luis Obispo, CA 93401-4140 | 2005-06-13 |
1790176543 | Diane De Vos-schmidt | Nurse Practitioner | 715 Tank Farm Road, Suite C, San Luis Obispo, CA 93401-7068 | 2015-02-16 |
1861609414 | Susan K Moon Labriola | Clinical Nurse Specialist | 715 Tank Farm Road, Suite C, San Luis Obispo, CA 93401-7068 | 2007-05-16 |
1457343113 | James M Malone IIi | Internal Medicine | 715 Tank Farm Road, Suite C, San Luis Obispo, CA 93401-7068 | 2005-08-18 |
1477558435 | Thomas J Spillane | Internal Medicine | 715 Tank Farm Road, Suite C, San Luis Obispo, CA 93401-7068 | 2005-06-16 |
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 | 364SX0204X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
Specialization | Oncology, Pediatrics |
Definition to come... |
City | SAN LUIS OBISPO |
Zip Code | 93401 |
Please comment or provide details below to improve the information on MARY M OKIMOTO.
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.