Provider Demographics
NPI:1558775817
Name:COUNTY OF SAN LUIS OBISPO
Entity Type:Organization
Organization Name:COUNTY OF SAN LUIS OBISPO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PUBLIC HEALTH NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:805-237-3054
Mailing Address - Street 1:2191 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-4534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2191 JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4534
Practice Address - Country:US
Practice Address - Phone:805-237-3054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA694880251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management