Individual provider Active NPI

Gilbert Rogacion Braulio, PHN, RN

  • Community Health Registered Nurse
  • San Diego, CA
National Provider Identifier
1265003339
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
561782 Issued in CA
Practice address
12473 Heatherton CT Apt 329
San Diego, CA 92128-5190
Phone
(619) 341-9803
NPI assigned
Jul 8, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 561782 CA Primary

Addresses

Primary practice location

12473 Heatherton CT Apt 329
San Diego, CA 92128-5190

Mailing address

12473 Heatherton CT Apt 329
San Diego, CA 92128-5190
Phone (619) 341-9803

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
561782CAMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1265003339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12473 HEATHERTON CT APT 329",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921285190",
            "telephone_number": "619-341-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12473 HEATHERTON CT APT 329",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921285190",
            "telephone_number": "619-341-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAULIO",
        "first_name": "GILBERT",
        "middle_name": "ROGACION",
        "credential": "PHN, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "561782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.