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EDNA VALLEY HEALTH CENTER
NPI 1588225353
Clinic/Center - Community Health in San Luis Obispo, CA

Active since June 24, 2019CLIA 05D2171329 · Waiver
4460 BROAD ST STE 110, SAN LUIS OBISPO, CA 93401(805) 597-6715(805) 541-4973 Get Directions Write a Review

NPPES record last updated: April 3, 2023. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Edna Valley Health Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDNA VALLEY HEALTH CENTER (NPI 1588225353) is a healthcare organization registered as a community health in San Luis Obispo, California and active in the NPI registry since June 2019. The organization holds a CLIA Waiver certificate valid through August 27, 2027 and lists Matthew Richardson, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1588225353
Entity TypeOrganization
Primary Taxonomy261QC1500X
Legal Business NamePACIFIC CENTRAL COAST HEALTH CENTERS
Location Address4460 BROAD ST STE 110San Luis Obispo, CA 93401-8065
Mailing Address1414 E Main St Ste 201Santa Maria, CA 93454-4890 · (805) 994-5485 · Fax (805) 739-3982
Phone(805) 597-6715
Fax(805) 541-4973
Organization SubpartYes
Authorized OfficialMatthew RichardsonChief Financial Officer · (805) 739-3475
Enumeration DateJune 24, 2019
Last NPPES UpdateApril 3, 2023
NPPES CertifiedApril 3, 2023
✔ NPI 1588225353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities
Taxonomy Code261QC1500X
4460 BROAD ST STE 110, San Luis Obispo, CA 93401
Open in Google Maps ↗

Other Names 1

Doing Business AsEdna Valley Health Center

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2171329

Edna Valley Health Center · San Luis Obispo, CA
Active · expires Aug 27, 2027
CLIA Number05D2171329
Laboratory TypeCommunity Clinic
Certificate Effective DateAugust 28, 2025
Certificate Expiration DateAugust 27, 2027
Laboratory DirectorOza Sowmya
Laboratory Phone(805) 541-1177
Laboratory LocationEdna Valley Health Center4460 Broad St Suite 110, San Luis Obispo, CA 93401
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GLADYS DESCARGAR FIELD MSN, APRN, ACNP-BC
Nurse Practitioner
4460 BROAD ST STE 110
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 597-6715
DR. SOWMYA OZA M.D.
Internal Medicine
4460 BROAD ST STE 110
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 597-6715
JOURDAN MACKENZIE MURO PA-C
Physician Assistant
4460 BROAD ST STE 110
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 597-6715

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pacific Central Coast Health Centers's NPI number?

The NPI number for Pacific Central Coast Health Centers is 1588225353. It was assigned to this organization in the NPPES registry on June 24, 2019. The provider is doing business as Edna Valley Health Center.

Where is Pacific Central Coast Health Centers located?

Pacific Central Coast Health Centers is located at 4460 Broad St Ste 110, San Luis Obispo, CA 93401. The listed phone number is (805) 597-6715.

What is Pacific Central Coast Health Centers's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

Does Pacific Central Coast Health Centers hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2171329) is associated with this NPI, valid through August 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pacific Central Coast Health Centers was last updated on April 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.