Individual provider Active NPI

Brittany Arlene Camille, FNP-BC, RN

  • Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1346940947
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95024692 Issued in CA
Practice address
11357 Lakeport Dr
Riverside, CA 92505-3470
Phone
(310) 344-1027
NPI assigned
Mar 3, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 803915 CA
Nurse Practitioner 363L00000X 95024692 CA Primary

Addresses

Primary practice location

11357 Lakeport Dr
Riverside, CA 92505-3470

Mailing address

11357 Lakeport Dr
Riverside, CA 92505-3470
Phone (310) 344-1027

Other identifiers 1

IdentifierTypeStateIssuer
95024692MedicaidCA

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629002566 CA Practitioner - Nurse Practitioner 6305205915 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Unicare Community Health Center Inc Current Accepting new patients
Unicare Community Health Center, Inc. CurrentSince May 20, 2023 Accepting new patients
Altais Medical Group - Riverside, Inc. Past Accepting new patients

Locations

17500 Foothill Blvd
Ste A2
Fontana, CA 92335
Phone (909) 428-0170

437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835

Interoperability endpoints

  • Direct secure messaging: brittany.camille.2@24668.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1346940947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11357 LAKEPORT DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053470",
            "telephone_number": "310-344-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11357 LAKEPORT DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053470",
            "telephone_number": "310-344-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMILLE",
        "first_name": "BRITTANY",
        "middle_name": "ARLENE",
        "name_prefix": "Dr.",
        "credential": "FNP-BC, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "803915",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95024692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95024692",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.