Individual provider Active NPI

Sean Bravo, BSN

  • Emergency Registered Nurse
  • Orange, CA
National Provider Identifier
1356020317
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
95183838 Issued in CA
Practice address
17817 Santiago Blvd
Orange, CA 92861-4133
Phone
(714) 363-3146
NPI assigned
Jul 17, 2023
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 95183838 CA Primary

Addresses

Primary practice location

17817 Santiago Blvd
Orange, CA 92861-4133

Mailing address

700 E Lake Dr Unit 27
Orange, CA 92866-2743

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
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
95183838CAMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1356020317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E LAKE DR UNIT 27",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928662743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17817 SANTIAGO BLVD",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928614133",
            "telephone_number": "714-363-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "SEAN",
        "credential": "BSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "95183838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.