Darrell Broussard II
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Highland, CA
NPI 1699616516 · NPPES record last updated Apr 3, 2026
Key facts
- NPI
- 1699616516
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 95038413 (CA)
- Practice address
- 7898 Portofino St
Highland, CA 92346-6378 - Phone
- (909) 327-7284
- NPI assigned
- Apr 3, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95038413 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95038413 | CA | Yes |
Addresses
Primary practice location
7898 Portofino St
Highland, CA 92346-6378
Mailing address
7898 Portofino St
Highland, CA 92346-6378
Phone (909) 327-7284
Other providers in Highland, CA
- Amanda Ann Blanton
- Judy F. Blodgett
- Catherine Bodman
- Amanda Bowen
- Katherine Boyko
- Joeann Brown
- Nelson Brown Jr.
- Suzanne Browning
- Cabio Inc
- Elizabeth Cerda Cabrera
All providers in Highland, CA · Psychiatric/Mental Health Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.