Jan D Brink, M.D.

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

A72078 Issued in CA

Practice address

11776 Mariposa Rd
Hesperia, CA 92345-1622

Phone

(760) 956-2462

NPI assigned

Oct 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• El Proyecto del Barrio, Inc.

  • Federally Qualified Health Center (FQHC)
  • Azusa, CA
  • NPI 1770696023
  Medicare reassignment NPD
• Dagmar I Liepa, MD

  • General Practice Physician
  • Van Nuys, CA
  • NPI 1881742047
  Medicare reassignment
• El Proyecto del Barrio, Inc.

  • Federally Qualified Health Center (FQHC)
  • Arleta, CA
  • NPI 1083624423
  NPD
• El Proyecto del Barrio, Inc.

  • Federally Qualified Health Center (FQHC)
  • Northridge, CA
  • NPI 1093181448
  NPD
• The Gooden Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Pasadena, CA
  • NPI 1821135393
  NPD
• Addictionmds PC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Van Nuys, CA
  • NPI 1306591185
  NPD (past)
• Dagmar Liepa, MD

  • Addiction Medicine (Preventive Medicine) Physician
  • Van Nuys, CA
  • NPI 1245558204
  NPD (past)
• Nationwide Medical Group, Inc

  • Community Health Clinic/Center
  • Stockton, CA
  • NPI 1548317951
  NPD (past)

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1326227992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11776 MARIPOSA RD",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451622",
            "telephone_number": "760-956-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11776 MARIPOSA RD",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451622",
            "telephone_number": "760-956-2462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 N El Molino Ave",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911011804",
            "country_code": "US",
            "telephone_number": "626-356-0078",
            "fax_number": "626-795-2844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRINK",
        "first_name": "JAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A72678",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "50186",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A72078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nazario Bravo, CHW
• Alyssa Brewer
• Brian Chu, D.D.S., Inc.
• Bright House Therapy LLC
• Dorothy Bright
• Hubert Charles Brock II, MA
• Serge Bronstein
• Rolanda Renee Brooks
• Ashley Megan Brooksher
• Cindy I Brown

• Addiction Medicine (Internal Medicine) Physician in Hesperia, CA
• Providers in Hesperia, CA by specialty
• Addiction Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.