Charnelle Breaux

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

220964 Issued in CA

Practice address

2720 E Palmdale Blvd Ste 129
Palmdale, CA 93550-4930

Phone

(661) 947-3333

NPI assigned

Dec 23, 2020

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• American Health Services LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Palmdale, CA
  • NPI 1861562019
  NPD
• Leave the Door Open LLC

  • Mental Illness Intermediate Care Facility
  • Lancaster, CA
  • NPI 1194567396
  NPD
• West County Medical Corp

  • Primary Care Clinic/Center
  • Palmdale, CA
  • NPI 1790044196
  NPD (past)

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

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1205423233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 E PALMDALE BLVD STE 129",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504930",
            "telephone_number": "661-947-3333",
            "fax_number": "661-575-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 E PALMDALE BLVD STE 129",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504930",
            "telephone_number": "661-947-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAUX",
        "first_name": "CHARNELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "220964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B7186314",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Palmdale",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Palmdale",
            "address_1": "2720 E Palmdale Blvd Ste 129",
            "city": "Palmdale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935504930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marina Michelle Bragasin, FNP
• Marlene Esmeralda Bran
• Leah Brandenburg, MFTI
• Susan Brasket
• William Steven Brawders, OD
• Elisabeth Michelle Breen
• Michael Breen
• Cathy Joan Brendemihl
• Tavia Destiny Brewer
• Kirk Brewster, D.D.S.

• Licensed Vocational Nurse in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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.