Active NPI
Bronwyn Purcell-Deabreu, DVM
- Other Technician
- Martinez, CA
National Provider Identifier
1063016319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 22511
- Practice address
- 4800 Imhoff PL
Martinez, CA 94553-4300 - Phone
- (925) 608-8428
- NPI assigned
- Nov 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Other Technician | 247200000X | 22511 | CA | Primary |
Addresses
Primary practice location
4800 Imhoff PL
Martinez, CA 94553-4300
Mailing address
1701 Shoreline Dr Apt 106
Alameda, CA 94501-6001
Phone (201) 927-4090
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 |
|---|---|---|---|
| 22511 | CA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606435200000",
"number": "1063016319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 SHORELINE DR APT 106",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945016001",
"telephone_number": "201-927-4090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 IMHOFF PL",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945534300",
"telephone_number": "925-608-8428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURCELL-DEABREU",
"first_name": "BRONWYN",
"credential": "DVM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-27",
"last_updated": "2020-11-27",
"certification_date": "2020-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "CA",
"license": "22511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.