Individual
AVERY JOHN PAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, NP
Contact information
Practice address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4558
(805) 431-1334
Mailing address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4558
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
686849
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95024036
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/19/2018
Last updated
06/02/2023
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