Innerbloom Ketamine Therapy
NPI 1184430696ActiveOrganization· Integrative Medicine· San Luis Obispo, CA
Integrative Medicine in San Luis Obispo, California, registered in NPPES in December 2024. The authorized official on file is Ray Rivas, MD, Md. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1184430696 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 9, 2024 |
| Last updated in NPPES | Mar 3, 2026 |
| Certified by provider | Mar 3, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Integrative Medicine Primary | 202D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|