DR. LISA INEZ SWEATT (NPI# 1760510556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760510556 |
| Entity Type | Individual |
| Full Name | DR. LISA INEZ SWEATT |
| Credential | PH.D. |
| Practice Address |
1 Grand Ave Cal Poly State Univ.,psychology & Child Dev. Department San Luis Obispo CA 93407-9000 |
| Mailing Address |
1718 9th St Los Osos CA 93402-2225 |
| Practice Telephone | 8057566123 |
| Practice Fax Number | 8057561134 |
| Mailing Telephone | 8057566123 |
| Mailing Fax Number | 8057561134 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
19226 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508279928 | Lisa Sweatt | Counselor | 2711 W 15th St, Panama City, FL 32401-1366 | 2014-06-03 |
| Street Address |
1 GRAND AVE CAL POLY STATE UNIV.,PSYCHOLOGY & CHILD DEV. DEPARTMENT |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93407-9000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972561728 | Keri Ann Eichenberger | Specialist/Technologist | 1 Grand Ave, Cp Athletics, San Luis Obispo, CA 93401 | 2006-05-02 |
| 1003300153 | Jay Bettergarcia | Psychologist | 1 Grand Ave, San Luis Obispo, CA 93407-9000 | 2018-06-20 |
| 1427427749 | Carol Anne Freeman | Nurse Practitioner | 1 Grand Ave, Cal Poly Health Services, San Luis Obispo, CA 93410-9001 | 2015-09-16 |
| 1093946287 | Kevin Mccarthy | General Practice | 1 Grand Ave, San Luis Obispo, CA 93407-0210 | 2009-08-05 |
| 1184854598 | Richard V Ascoli | Family Medicine | 1 Grand Ave, San Luis Obispo, CA 93407-9000 | 2009-07-20 |
| 1942464920 | June Gelling | Pharmacist | 1 Grand Ave, San Luis Obispo, CA 93407-9000 | 2008-07-18 |
| 1902086150 | California Polytechnic State University At San Luis Obispo | Clinic/Center | 1 Grand Ave, San Luis Obispo, CA 93407-9000 | 2007-11-05 |
| 1356548051 | Valerie Veronica Monge | Physician Assistant | 1 Grand Ave, San Luis Obispo, CA 93407-9000 | 2007-06-27 |
| 1902928542 | Raechel Nicole Cunningham | Specialist/Technologist | 1 Grand Ave, San Luis Obispo, CA 93407-9000 | 2007-04-04 |
| 1255456901 | Paul Eric Gabrielson | Specialist/Technologist | 1 Grand Ave, Athletics, San Luis Obispo, CA 93407-9000 | 2007-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730244377 | Marilyn Jane Pieters | Nurse Practitioner | Cal Poly State University Student Health Services, San Luis Obispo, CA 93407 | 2006-12-26 |
| 1750442653 | California Polytechnic State University At San Luis Obispo | Clinic/Center | Cal Poly Health Services, Grand Ave., San Luis Obispo, CA 93407 | 2006-12-13 |
| 1710065461 | Marina E Perez | Nurse Practitioner | 1 Grand Ave., Cal Poly Health Services, San Luis Obispo, CA 93407 | 2006-11-01 |
| 1447435912 | Cal Poly Health Services | Clinic/Center | 1 Grand Ave Building 27, Cal Poly State University, San Luis Obispo, CA 93407-0000 | 2008-01-03 |
| 1275739245 | Nancy J Walden | Nurse Practitioner | Cal Poly State Health Center, 1 Grand Ave Building 27, San Luis Obispo, CA 93407-0210 | 2007-06-26 |
| 1558475699 | Mark Mason Haley | Physician Assistant | One Grand Ave, San Luis Obispo, CA 93407-0210 | 2006-08-18 |
| 1417194408 | Norman Brooks Smith | Family Medicine | 1 Grand Ave., Cal Poly Health Services, San Luis Obispo, CA 93407-0210 | 2009-01-13 |
| 1720140288 | Cal Poly Health Services | Clinic/Center | Health Services, California Polytechnic State University, San Luis Obispo, CA 93407-0210 | 2006-12-14 |
| 1750450680 | David Lloyd Harris | Internal Medicine | Health Services, California Polytechnic State University, San Luis Obispo, CA 93407-0210 | 2006-11-07 |
| 1578694675 | Student Health Service Pharmacy | Pharmacy | 1 Grand Ave Bldg 27, Health Center, San Luis Obispo, CA 93407-9000 | 2007-03-08 |
| Find all providers in zip 93407 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134582299 | Taylor Foster Smith | Psychologist | 1411 Marsh St, Suite 106, San Luis Obispo, CA 93401-2957 | 2016-04-05 |
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| 1003478405 | Melissa Berrenge-browde | Psychologist | 820 Bay Avenue, Suite 205, Capitola, CA 95010-2102 | 2019-07-05 |
| 1811555840 | Rebecca Cole | Psychologist | 5149 High Meadow Court, Fremont, CA 94536 | 2019-06-04 |
| Find all providers with the same taxonomy | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93407 |
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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.