| Loma Vista Community School | |
|
2494 Pennington Creek Rd San Luis Obispo CA 93405-7841 | |
| (805) 781-4700 | |
| Not Available |
| Full Name | Loma Vista Community School |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2494 Pennington Creek Rd, San Luis Obispo, California |
| Authorized Official Name and Position | M Dailsy Ilano (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8057814700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Loma Vista Community School 2178 Johnson Ave San Luis Obispo CA 93401-4535 Ph: () - | Loma Vista Community School 2494 Pennington Creek Rd San Luis Obispo CA 93405-7841 Ph: (805) 781-4700 |
| NPI Number | 1033512561 |
|---|---|
| Provider Enumeration Date | 09/29/2014 |
| Last Update Date | 09/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033512561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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