Porsha Brooks
Individual provider Active NPI Case Manager/Care Coordinator · Ceres, CA
NPI 1104546118 · NPPES record last updated Sep 14, 2023
Key facts
- NPI
- 1104546118
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 3607 Blaker Rd
Ceres, CA 95307-9503 - Phone
- (209) 531-1783
- NPI assigned
- Aug 30, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
3607 Blaker Rd
Ceres, CA 95307-9503
Mailing address
584 E Bellevue Rd
Atwater, CA 95301-2300
Other practice location 1
584 E Bellevue Rd
Atwater, CA 95301-2300
Phone (559) 747-2177
Other practice location 2
1708 Banyan Ct
Ceres, CA 95307-1907
Phone (209) 538-1888
Other practice location 3
2528 Leslie Ln
Ceres, CA 95307-2326
Phone (209) 538-7331
Other practice location 4
3212 Uranus Dr
Ceres, CA 95307-3010
Phone (209) 538-4038
Other providers in Ceres, CA
- Ana-Karen Brambila
- Joel Brambila I
- Adrian Bravo
- Kristina Brenner
- James F Briggs
- Shavontay Jenaye Brooks
- Daesha Brown
- Daniel Wayne Brown Jr.
- Garry Henry Brown
- Julia Lynette Brown
All providers in Ceres, CA · Case Manager/Care Coordinator in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.