Active NPI
Lily Breen
- Registered Nurse
- San Rafael, CA
National Provider Identifier
1033574660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 95073674
- Practice address
- 54 Crestwood Dr
San Rafael, CA 94901-1150 - Phone
- (415) 246-6705
- NPI assigned
- Dec 26, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95073674 | CA | Primary |
Addresses
Primary practice location
54 Crestwood Dr
San Rafael, CA 94901-1150
Mailing address
54 Crestwood Dr
San Rafael, CA 94901-1150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95073674 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451088000000",
"number": "1033574660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 CRESTWOOD DR",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949011150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 CRESTWOOD DR",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949011150",
"telephone_number": "415-246-6705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREEN",
"first_name": "LILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-26",
"last_updated": "2015-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95073674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
- Ellen Irish Branco, MSW, MPH
- Marilyn Ladean Brandon, SOCIAL WORKER II
- Christine Eva Ann Brandt
- Mandy S. Delois Brantley, MS
- Tess Bratkovich
- Rebecca Wood Breen, LCSW
- Katherine O Bregar
- Ingrid Kristina Brennan, MD
- Kelly Breslin, RBT
- Brett V. Curtis, MD, a Professional Corporation, Inc. (Medical Center of Marin)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.