Provider Demographics
NPI:1134499908
Name:GARRETT, MARY B (NP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:B
Last Name:GARRETT
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1551 BISHOP ST
Mailing Address - Street 2:SUITE A-150
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-4693
Mailing Address - Country:US
Mailing Address - Phone:805-541-6000
Mailing Address - Fax:805-541-6001
Practice Address - Street 1:1551 BISHOP ST
Practice Address - Street 2:SUITE A-150
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4693
Practice Address - Country:US
Practice Address - Phone:805-541-6000
Practice Address - Fax:805-541-6001
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA377062363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health