Active NPI
Rosann Christine Brizuela
- Dental Assistant
- Riverside, CA
National Provider Identifier
1497312508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- RDA92694
- Practice address
- 3380 La Sierra Ave Ste 108
Riverside, CA 92503-5225 - Phone
- (951) 465-6982
- NPI assigned
- May 23, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | RDA92694 | CA | Primary |
Addresses
Primary practice location
3380 La Sierra Ave Ste 108
Riverside, CA 92503-5225
Mailing address
3380 La Sierra Ave Ste 108
Riverside, CA 92503-5225
Phone (951) 465-6982
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RDA92694 | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RDA92694 | CA | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558569600000",
"number": "1497312508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3380 LA SIERRA AVE STE 108",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925035225",
"telephone_number": "951-465-6982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3380 LA SIERRA AVE STE 108",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925035225",
"telephone_number": "951-465-6982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIZUELA",
"first_name": "ROSANN",
"middle_name": "CHRISTINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-23",
"last_updated": "2019-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "RDA92694",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RDA92694",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.