Individual provider Active NPI

Brianna Dustin

  • Rehabilitation Practitioner
  • Eureka, CA
National Provider Identifier
1811671290
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
2259 Myrtle Ave
Eureka, CA 95501-3325
Phone
(707) 444-8293
Fax
(707) 444-8298
NPI assigned
Jun 14, 2023
Last updated
Jun 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X NU Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

2259 Myrtle Ave
Eureka, CA 95501-3325

Mailing address

723 W Long St
Eureka, CA 95501-3546
Phone (707) 630-2865

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": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1811671290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 W LONG ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013546",
            "telephone_number": "707-630-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2259 MYRTLE AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013325",
            "telephone_number": "707-444-8293",
            "fax_number": "707-444-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSTIN",
        "first_name": "BRIANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.