Individual provider Active NPI

Randy Leo Brissette

  • Case Management Agency
  • Valencia, CA
National Provider Identifier
1770766263
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Practice address
23759 W Valencia Blvd
Valencia Sub Office
Valencia, CA 91355
Phone
(661) 253-7271
Fax
(661) 974-7055
NPI assigned
Dec 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

23759 W Valencia Blvd
Valencia Sub Office
Valencia, CA 91355

Mailing address

9150 East Imperial Hwy
RM P-31
Downey, CA 90242
Phone (562) 940-3694

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

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1770766263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9150 EAST IMPERIAL HWY",
            "address_2": "RM P-31",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "90242",
            "telephone_number": "562-940-3694",
            "fax_number": "562-658-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23759 W VALENCIA BLVD",
            "address_2": "VALENCIA SUB OFFICE",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "91355",
            "telephone_number": "661-253-7271",
            "fax_number": "661-974-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISSETTE",
        "first_name": "RANDY",
        "middle_name": "LEO",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-07",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.