MS. CAROL SUE FUENTES (NPI# 1619918570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619918570 |
| Entity Type | Individual |
| Full Name | MS. CAROL SUE FUENTES |
| Credential | MS PA-C |
| Practice Address |
1288 Morro St San Luis Obispo CA 93401-6301 |
| Mailing Address |
1288 Morro St San Luis Obispo CA 93401-6302 |
| Practice Telephone | 8055431233 |
| Mailing Telephone | 8055431233 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA15472 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134517501 | Carol Fuentes | Occupational Therapist | 625 N Main St, Boerne, TX 78006-1621 | 2015-01-07 |
| Street Address |
1288 MORRO ST |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93401-6301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174561799 | West Los Angeles Vamc | Clinic/Center | 1288 Morro St, Suite 200, San Luis Obispo, CA 93401-6301 | 2006-06-04 |
| 1114254307 | Katherine Ann Stevens | Registered Nurse | 1288 Morro St, San Luis Obispo, CA 93401-6301 | 2009-11-09 |
| 1588830269 | John Alexander Freeman | Dentist | 1288 Morro St, Suite #110, San Luis Obispo, CA 93401-6301 | 2008-05-02 |
| 1699707752 | Surya-rao Pakalapati | Internal Medicine | 1288 Morro St, Suite 200, San Luis Obispo, CA 93401-6301 | 2006-07-07 |
| 1497786388 | Wilma Kathleen Mechsner | Nurse Practitioner | 1288 Morro St, Suite 200, San Luis Obispo, CA 93401-6301 | 2006-07-06 |
| 1710923933 | Mark Flavius Donaldson | Internal Medicine | 1288 Morro St, Suite 200, San Luis Obispo, CA 93401-6301 | 2006-06-22 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053777342 | Kellie Acosta | Physician Assistant | 275 N Chorro St, Apt E, San Luis Obispo, CA 93405-3320 | 2016-01-03 |
| 1942646393 | Shermin Yaghoubi Rutherford | Physician Assistant | 35 Casa St Ste 370, San Luis Obispo, CA 93405-5835 | 2013-05-13 |
| 1235613191 | Claudia Franke | Physician Assistant | 1304 Ella St Ste A, San Luis Obispo, CA 93401-4165 | 2018-09-17 |
| 1770938532 | Cheryl Ketelsen | Physician Assistant | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2016-04-29 |
| 1134584014 | Justin Schmidt | Physician Assistant | 1428 Phillips Ln Ste 203, San Luis Obispo, CA 93401 | 2015-12-21 |
| 1508020462 | Elizabeth Ann Spears | Physician Assistant | 1551 Bishop St, Suite 220, San Luis Obispo, CA 93401-4635 | 2008-07-10 |
| 1508064593 | Katherine Jane Berman | Physician Assistant | 283 Madonna Rd, San Luis Obispo, CA 93405-5432 | 2007-07-11 |
| 1114128956 | Carolyn Ann Smith | Physician Assistant | 1551 Bishop St, 220, San Luis Obispo, CA 93401-4635 | 2007-05-30 |
| 1134330756 | David Sanford Levy | Physician Assistant | 10 Santa Rosa St, Ste. 201, San Luis Obispo, CA 93405-5825 | 2007-05-25 |
| 1306975743 | Bonnie Heikes | Physician Assistant | 705 Grand Ave, San Luis Obispo, CA 93401-2639 | 2007-03-03 |
| 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 MS. CAROL SUE FUENTES.
| 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.