Healthcare Provider Details

I. General information

NPI: 1447326566
Provider Name (Legal Business Name): LUPE VARELA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W FOSTER RD
SANTA MARIA CA
93455-3620
US

IV. Provider business mailing address

1026 LIBERTY ST
SANTA MARIA CA
93458-6858
US

V. Phone/Fax

Practice location:
  • Phone: 805-934-6340
  • Fax:
Mailing address:
  • Phone: 805-540-0371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-OUISYA
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: