Active NPI
Joanna J Brazzle
- Athletic Trainer
- Gardena, CA
National Provider Identifier
1851938609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 2920 W 135TH PL
Gardena, CA 90249-2302 - Phone
- (310) 488-2178
- NPI assigned
- Nov 27, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
2920 W 135TH PL
Gardena, CA 90249-2302
Mailing address
2920 W 135TH PL
Gardena, CA 90249-2302
Phone (310) 488-2178
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA | |
| NA | Other | N/A |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | N/A | Direct | |
| CONNECT URL | N/A |
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": "1574812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574812800000",
"number": "1851938609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2920 W 135TH PL",
"city": "GARDENA",
"state": "CA",
"postal_code": "902492302",
"telephone_number": "310-488-2178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2920 W 135TH PL",
"city": "GARDENA",
"state": "CA",
"postal_code": "902492302",
"telephone_number": "310-488-2178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAZZLE",
"first_name": "JOANNA",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-27",
"last_updated": "2019-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "NA",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "N/A",
"identifier": "NA",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "N/A",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2920 W 135th Pl",
"city": "Gardena",
"state": "CA",
"country_code": "US",
"postal_code": "902492302",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "N/A",
"affiliation": "N",
"address_1": "2920 W 135th Pl",
"city": "Gardena",
"state": "CA",
"country_code": "US",
"postal_code": "902492302",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.