Josselynn Annette Brewer

Individual provider Active NPI Other Technician · Morro Bay, CA

NPI 1811717366 · NPPES record last updated Oct 10, 2024

Key facts

NPI
1811717366
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
License
R1569860724 (CA)
Practice address
2460 Main St
Morro Bay, CA 93442-1552
Phone
(805) 772-2212
NPI assigned
Oct 10, 2024
Sex
Female
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

LicenseStateTypeSpecialty
R1569860724CAMDOther Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X R1569860724 CA Yes

Addresses

Primary practice location

2460 Main St
Morro Bay, CA 93442-1552

Mailing address

2460 Main St
Morro Bay, CA 93442-1552
Phone (805) 772-2212

Other names

  • Josselynn Annette Nogo Other name

Other providers in Morro Bay, CA

All providers in Morro Bay, CA · Other Technician in California

Sources for this page

Verify at the official NPI Registry.