Individual provider Active NPI

Brandi O'Brien

  • Pediatric Nurse Practitioner
  • Torrance, CA
National Provider Identifier
1386969731
Registry record updated Sep 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
19428 Issued in CA
Practice address
5315 Torrance Blvd
Torrance, CA 90503-4011
Phone
(310) 543-3400
NPI assigned
Mar 29, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 19428 CA Primary

Addresses

Primary practice location

5315 Torrance Blvd
Torrance, CA 90503-4011

Mailing address

5315 Torrance Blvd
Torrance, CA 90503-4011
Phone (310) 543-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240726003385 OR Practitioner - Nurse Practitioner 8820424088 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19428CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Jun 1, 2024 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 1, 2024 Accepting new patients

Locations

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

Organizations & group practices 2

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": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442188800000",
    "number": "1386969731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 TORRANCE BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034011",
            "telephone_number": "310-543-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 TORRANCE BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034011",
            "telephone_number": "310-543-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "BRANDI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-29",
        "last_updated": "2015-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "19428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.