Individual provider Active NPI

Brianne Dimiceli

  • School Registered Nurse
  • Fremont, CA
National Provider Identifier
1578360830
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
95040252 Issued in CA
Practice address
38442 Fremont Blvd
Fremont, CA 94536-6031
Phone
(510) 505-7300
NPI assigned
Feb 25, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 95040252 CA Primary

Addresses

Primary practice location

38442 Fremont Blvd
Fremont, CA 94536-6031

Mailing address

4210 Technology Dr
Fremont, CA 94538-6337
Phone (510) 993-7954

Other practice location 1

40292 Leslie St
Fremont, CA 94538-3520
Phone (510) 657-7080

Other practice location 2

43545 Bryant St
Fremont, CA 94539-5838
Phone (510) 656-1200

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

LicenseStateTypeSpecialty
95040252CAMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
City of Fremont PastSince Aug 30, 2020 Accepting new patients

Organizations & group practices 1

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": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1578360830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 TECHNOLOGY DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945386337",
            "telephone_number": "510-993-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38442 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945366031",
            "telephone_number": "510-505-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40292 Leslie St",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945383520",
            "country_code": "US",
            "telephone_number": "510-657-7080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "43545 Bryant St",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945395838",
            "country_code": "US",
            "telephone_number": "510-656-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIMICELI",
        "first_name": "BRIANNE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "CA",
            "license": "95040252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.