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NPI Code Detail

MEDICARE: MRS. JANA KATHLIN CEARLEY LPT

MEDICARE: MRS. JANA KATHLIN CEARLEY LPT
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 TechnicianPT25783CA

General Provider Information

NPI Number : 1659415156
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANA KATHLIN CEARLEY LPT
Provider Business Mailing Address
First Line : 2180 JOHNSON AVE
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4558
Country : US
Telephone Number : 805-781-4334
Fax Number :
Provider Business Practice Location Address
First Line : 2180 JOHNSON AVE
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4558
Country : US
Telephone Number : 805-781-4334
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2007
Last Update Date : 09/10/2025

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