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Mrs. Carolyn Nmn Shively
Licensed Psychiatric Technician in San Luis Obispo, California
NPI 1518025725

Carolyn Nmn Shively is a Licensed Psychiatric Technician based in Morro Bay, CA. Carolyn Nmn Shively practices in San Luis Obispo, CA. The NPI Number for Carolyn Nmn Shively is 1518025725 and holds a License No. 13693 (California).

The current practice location address for Carolyn Nmn Shively is 2178 Johnson Ave, San Luis Obispo, CA and can be reached out via phone at 805-781-4738 and via fax at 805-781-1232. You can also correspond with Carolyn Nmn Shively through the mailing address at 461 YERBA BUENA ST, MORRO BAY, CA - 93442-2973 (mailing address contact number: 805-772-6992).

Location: 2178 Johnson Ave, San Luis Obispo, CA, 93442-2973
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518025725
Provider Name
Carolyn Nmn Shively
Credential
Provider Entity Type
Individual
Gender
Female
Address
2178 Johnson Ave, San Luis Obispo, CA, 93442-2973
Phone Number
805-781-4738
Fax Number
805-781-1232
Provider Enumeration Date
12/04/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
2178 Johnson Ave
City
San Luis Obispo
State
California
Zip
93401-4535
Phone Number
805-781-4738
Fax Number
805-781-1232
person
Provider Business Mailing Address Details
Address
461 Yerba Buena St
City
Morro Bay
State
California
Zip
93442-2973
Phone Number
805-772-6992
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Psychiatric Technician
Speciality
-
Taxonomy
167G00000X
License No.
13693 (California)
Definition
An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities.
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