Active NPI
Nicholas Jay Brecht, PA-C
- Physician Assistant
- Los Alamitos, CA
National Provider Identifier
1205095205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA19780
- Practice address
- 11302A Independence Rd
Los Alamitos, CA 90720-5155 - Phone
- (562) 795-2507
- NPI assigned
- Jun 4, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA19780 | CA | Primary |
Addresses
Primary practice location
11302A Independence Rd
Los Alamitos, CA 90720-5155
Mailing address
9539 Carnation Ave
Fountain Valley, CA 92708-1506
Phone (619) 964-2449
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 |
|---|---|---|---|
| PA19780 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658880000000",
"number": "1205095205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9539 CARNATION AVE",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927081506",
"telephone_number": "619-964-2449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11302A INDEPENDENCE RD",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "907205155",
"telephone_number": "562-795-2507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRECHT",
"first_name": "NICHOLAS",
"middle_name": "JAY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-04",
"last_updated": "2022-07-27",
"certification_date": "2022-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA19780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Alamitos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.