Kimberly A Breneisen, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G83111 Issued in CA

Practice address

2020 Sutter PL
Suite 201
Davis, CA 95616-6201

Phone

(530) 750-5959

Fax

(530) 750-5960

NPI assigned

Aug 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: kbreneisenmd20684@hisp.ehr.sutterhealth.org

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1831101997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 SUTTER PL",
            "address_2": "SUITE 201",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956166201",
            "telephone_number": "530-750-5959",
            "fax_number": "530-750-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENEISEN",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G83111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G831110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brainefit LLC.
• KC Renee Braley
• Julia Michelle Braun
• Bradley Jay Brazill, PHARM.D.
• Breakthrough Education Support
• Catherine Schuyler Brennan, MD
• Jeanne Brewer, DMD
• Keith Frederic Brewer, M.D.
• Kelly Ann Brewer, D.D.S.
• Stacey Diane Brezing, M.S., ACSM-RCEP

• Pediatrics Physician in Davis, CA
• Providers in Davis, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; 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.