MEDICARE: JEREMY ACEVEDO

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
1	1041C0700X	Clinical Social Worker	88020	CA

General Provider Information

NPI Number	:	1891033544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMY ACEVEDO

Provider Business Mailing Address
First Line	:	1017 N CONCEPCION AVE
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-2321
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1303 E GRAND AVE
Second Line	:
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-2460
Country	:	US
Telephone Number	:	805-242-3178
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2013
Last Update Date	:	02/24/2026

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Directions to “ JEREMY ACEVEDO ” Practice Location

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