Prudence Armandine Broadwell, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC3178 Issued in CA

Practice address

18837 Brookhurst St
Suite 210
Fountain Valley, CA 92708

Phone

(714) 965-9266

Fax

(714) 965-9268

NPI assigned

May 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174737522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18837 BROOKHURST ST",
            "address_2": "SUITE 210",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-965-9266",
            "fax_number": "714-965-9268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18837 BROOKHURST ST",
            "address_2": "SUITE 210",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-965-9266",
            "fax_number": "714-965-9268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADWELL",
        "first_name": "PRUDENCE",
        "middle_name": "ARMANDINE",
        "name_prefix": "Dr.",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC3178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Lee, DDS, Inc.
• Alecia Bridgefort, BA
• Dustin Lowell Briggs, CST, CSFA
• Bristol Park Medical Group, Inc
• Elivet Brito Ruiz-Ramos, M.S.
• Benjamin Edward Brodie, CMT, NMT
• Suzanne Brodsly, LCSW
• Mark A. Bronstein, M.D.
• Brookhurst Residential, Inc.
• Valery Brouwer, MD

• Acupuncturist in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.