Sandra Brackman, RN, PHN

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

565255 Issued in CA

Practice address

2674 Main St
Ramona, CA 92065-2553

Phone

(619) 518-7960

NPI assigned

Jun 16, 2023

Last updated

Jun 16, 2023By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1686873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1750066866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 MAIN ST UNIT 3814",
            "city": "RAMONA",
            "state": "CA",
            "postal_code": "920658242",
            "telephone_number": "760-855-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2674 MAIN ST",
            "city": "RAMONA",
            "state": "CA",
            "postal_code": "920652553",
            "telephone_number": "619-518-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKMAN",
        "first_name": "SANDRA",
        "credential": "RN, PHN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-16",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "565255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Registered Nurse in Ramona, CA
• Providers in Ramona, CA by specialty
• Community Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.