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NPI Code Detail

MEDICARE: MR. JASON MICHAEL HOOSON PSYCHIATRIC TECHNICI

MEDICARE: MR. JASON MICHAEL HOOSON PSYCHIATRIC TECHNICI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1167G00000XLicensed Psychiatric TechnicianPT28879CA

General Provider Information

NPI Number : 1083772933
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JASON MICHAEL HOOSON PSYCHIATRIC TECHNICI
Provider Business Mailing Address
First Line : 2178 JOHNSON AVE
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4535
Country : US
Telephone Number : 805-781-4179
Fax Number : 805-781-1265
Provider Business Practice Location Address
First Line : 2178 JOHNSON AVE
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4535
Country : US
Telephone Number : 805-781-4179
Fax Number : 805-781-1265
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2006
Last Update Date : 01/21/2025

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Directions to “ MR. JASON MICHAEL HOOSON PSYCHIATRIC TECHNICI” Practice Location

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