COUNTY OF SAN LUIS OBISPO (NPI# 1295059368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295059368 |
| Entity Type | Organization |
| Organization Name | COUNTY OF SAN LUIS OBISPO |
| Other Organization Name | MARTHA'S PLACE |
| Practice Address |
2925 Mcmillan Ave Ste 108 San Luis Obispo CA 93401-6765 |
| Mailing Address |
2178 Johnson Ave San Luis Obispo CA 93401-4535 |
| Practice Telephone | 8057814700 |
| Practice Fax Number | 8057811273 |
| Mailing Telephone | 8057814700 |
| Mailing Fax Number | 8057811273 |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2013-08-22 |
| Authorized Official Name | M. DAISY ILANO (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8057814700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 4083 | 05 |
| Other Name | Type Code |
|---|---|
| Martha's Place | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457902579 | County of San Luis Obispo | Clinic/Center | 406 Spring St, Paso Robles, CA 93446-3126 | 2019-09-20 |
| 1265945182 | County of San Luis Obispo | Community/Behavioral Health | 2820 Santa Rosa Creek Rd, Cambria, CA 93428-3524 | 2017-11-14 |
| 1134648603 | County of San Luis Obispo | Community/Behavioral Health | 1499 San Luis Dr, San Luis Obispo, CA 93401-3060 | 2017-09-15 |
| 1932563053 | County of San Luis Obispo | Clinic/Center | 1350 E Grand Ave, Arroyo Grande, CA 93420-2422 | 2016-04-06 |
| 1659776888 | County of San Luis Obispo | Community/Behavioral Health | 3500 El Camino Real, Atascadero, CA 93422-4189 | 2014-10-30 |
| 1679976104 | County of San Luis Obispo | Community/Behavioral Health | 1511 19th St, Oceano, CA 93445 | 2014-09-29 |
| 1770986291 | County of San Luis Obispo | Community/Behavioral Health | 920 W Tefft St, Nipomo, CA 93444-9624 | 2014-09-29 |
| 1366844011 | County of San Luis Obispo | Community/Behavioral Health | 1555 El Morro Ave, Los Osos, CA 93402-1910 | 2014-09-24 |
| 1831519875 | County of San Luis Obispo | Clinic/Center | 2180 Johnson Ave Fl 1, San Luis Obispo, CA 93401-4513 | 2014-04-17 |
| 1952736647 | County of San Luis Obispo | Community/Behavioral Health | 801 Grand Ave, San Luis Obispo, CA 93401-2641 | 2013-09-12 |
| Street Address |
2925 MCMILLAN AVE STE 108 |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93401-6765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831396258 | Laura Ann Ottrando | Registered Nurse | 2925 Mcmillan Ave Ste 108, San Luis Obispo, CA 93401-6765 | 2007-06-29 |
| 1316567183 | Laura Tomlinson | Student in an Organized Health Care Education/Training Program | 2925 Mcmillan Ave Ste 108, San Luis Obispo, CA 93401-6765 | 2020-04-22 |
| 1649838574 | Emily Weatherby | Marriage & Family Therapist | 2925 Mcmillan Ave Ste 108, San Luis Obispo, CA 93401-6765 | 2019-06-05 |
| 1902464209 | Diana Northness | Marriage & Family Therapist | 2925 Mcmillan Ave Ste 108, San Luis Obispo, CA 93401-6765 | 2019-05-31 |
| 1508391038 | Erica Collins | Marriage & Family Therapist | 2925 Mcmillan Ave Ste 108, San Luis Obispo, CA 93401-6765 | 2017-04-21 |
| 1770951220 | Shannon Lee Pacaoan | Social Worker | 2925 Mcmillan Ave Ste 108, San Luis Obispo, CA 93401-6765 | 2015-09-14 |
| 1609116060 | Allison Gayle Sommers | Social Worker | 2925 Mcmillan Ave Ste 108, San Luis Obispo, CA 93401-6765 | 2013-02-22 |
| 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 | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396803870 | County of San Luis Obispo | Clinic/Center | 1989 Vincente Dr, Bldg A, San Luis Obispo, CA 93405-0001 | 2006-12-05 |
| 1295110674 | Balance Treatment Slo, Inc | Clinic/Center | 1551 Bishop St, Ste 130a, San Luis Obispo, CA 93401-4635 | 2015-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073112157 | 10-20 Club Inc. | Clinic/Center | 8221 3rd St Ste 403, Downey, CA 90241-3733 | 2020-10-20 |
| 1447857040 | Mary Cox, Lmft | Clinic/Center | 13800 Heacock St Ste 230a, Moreno Valley, CA 92553-8824 | 2020-10-06 |
| 1821607771 | Tonya Octave, Lcsw, Prof Corp | Clinic/Center | 237 S Lakeview Ave Ste A, Placentia, CA 92870-6756 | 2020-07-27 |
| 1972121762 | Environmental Alternatives Susanville | Clinic/Center | 2003 Main St, Susanville, CA 96130-4501 | 2020-07-08 |
| 1083231781 | Treehouse Child Therapy Professional Corporation | Clinic/Center | 514 N California Ave Ste 13, Beaumont, CA 92223-2120 | 2020-06-29 |
| 1083230262 | Socal Adolescent Wellness, Inc. | Clinic/Center | 23072 Lake Center Dr Ste 214, Lake Forest, CA 92630-2899 | 2020-06-23 |
| 1447876123 | P.h.i.l.o.s.adolescent Treatment Centers, Inc. | Clinic/Center | 454 E Cerritos St, Rialto, CA 92376-3658 | 2020-06-18 |
| 1669098505 | Rowi Valencia, Inc. | Clinic/Center | 27413 Tourney Rd Ste 150, Valencia, CA 91355-5604 | 2020-06-16 |
| 1386267870 | Bni Treatment Centers | Clinic/Center | 2563 Stokes Canyon Rd, Calabasas, CA 91302-2991 | 2020-05-19 |
| 1538781042 | P.h.i.l.o.s.adolescent Treatment Centers, Inc. | Clinic/Center | 3872 Carthage St, Riverside, CA 92501-2102 | 2020-05-07 |
| Find all providers with the same taxonomy | ||||
| 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.