Individual provider Active NPI

Drue Graecyn Brotman

  • Behavior Technician
  • San Luis Obispo, CA
National Provider Identifier
1114835824
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
WDL36316D33B Issued in WA
Practice address
1212 Marsh St Ste 1
San Luis Obispo, CA 93401-3346
Phone
(805) 703-2120
NPI assigned
Sep 1, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X WDL36316D33B WA Primary

Addresses

Primary practice location

1212 Marsh St Ste 1
San Luis Obispo, CA 93401-3346

Mailing address

996 Royal Marco Way
Marco Island, FL 34145-1829
Phone (818) 345-2345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1114835824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 ROYAL MARCO WAY",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341451829",
            "telephone_number": "818-345-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 MARSH ST STE 1",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013346",
            "telephone_number": "805-703-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTMAN",
        "first_name": "DRUE",
        "middle_name": "GRAECYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-01",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "WDL36316D33B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.