Individual provider Active NPI

Natalie Elise Brazeau

  • Specialist
  • Walnut Creek, CA
National Provider Identifier
1104232016
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
2730 Shadelands Dr BLDG 10
Walnut Creek, CA 94598
Phone
(925) 768-0169
NPI assigned
Jul 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Specialist 174400000X Primary

Addresses

Primary practice location

2730 Shadelands Dr BLDG 10
Walnut Creek, CA 94598

Mailing address

2730 Shadelands Dr BLDG 10
Walnut Creek, CA 94598-2538
Phone (925) 768-0169

Other practice location 1

225 37th Ave
3rd Floor
San Mateo, CA 94403-4324
Phone (775) 720-7417

Other practice location 2

744 Empire St Ste 160
Fairfield, CA 94533
Phone (775) 720-7417

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1104232016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 SHADELANDS DR BLDG 10",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982538",
            "telephone_number": "925-768-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 SHADELANDS DR BLDG 10",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94598",
            "telephone_number": "925-768-0169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 37th Ave",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944034324",
            "country_code": "US",
            "telephone_number": "775-720-7417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "744 Empire St Ste 160",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "94533",
            "country_code": "US",
            "telephone_number": "775-720-7417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAZEAU",
        "first_name": "NATALIE",
        "middle_name": "ELISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-11",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.