Healthcare Provider Details

I. General information

NPI: 1477200954
Provider Name (Legal Business Name): SCARLETT ELIZABETH HARRIS CARDER CNM, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2022
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 CASA ST STE 220
SAN LUIS OBISPO CA
93405-1890
US

IV. Provider business mailing address

35 CASA ST STE 220
SAN LUIS OBISPO CA
93405-1890
US

V. Phone/Fax

Practice location:
  • Phone: 805-595-1808
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95019855
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: