Breane Fulson, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95031962 Issued in CA

Practice address

1706 S Bascom Ave
Suite# 140
Campbell, CA 95008

Phone

(408) 728-9888

NPI assigned

Mar 5, 2025

Last updated

Mar 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Breane Smallwood Other name

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carbon Health Medical Group of California PCGroup PAC ID 9032340047, 335 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carbon Health Medical Group of California PC

  dba Carbon Health

  • Urgent Care Clinic/Center
  • Berkeley, CA
  • NPI 1417294232
  Medicare reassignment Care Compare group NPD
• Carbon Health Primary Care of California PC

  • Multi-Specialty Clinic/Center
  • Berkeley, CA
  • NPI 1972057990
  NPD

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

{
    "created_epoch": "1741132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1447058458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 S BASCOM AVE",
            "address_2": "SUITE 140",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "95008",
            "telephone_number": "408-728-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 S BASCOM AVE",
            "address_2": "SUITE# 140",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "95008",
            "telephone_number": "408-728-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULSON",
        "first_name": "BREANE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95031962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANE",
            "last_name": "SMALLWOOD",
            "credential": "FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kory Fricks, MA, LMFT
• Haley Rose Frizzell
• Ronald David Fry, D.C.
• Tracey Fuller
• Christian James Fulmer, DO
• Jasmine Fulton
• Gabrielle Nicole Gabai, LMFT, LPCC
• Jeremiah Gacusan
• James Gajewkski
• Angelina M Gallegos, DNP, FNP, PMHNP

• Nurse Practitioner in Campbell, CA
• Providers in Campbell, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.