Individual provider Active NPI

Braden Yzaguirre

  • Physician Assistant
  • San Bernardino, CA
National Provider Identifier
1861210452
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65348 Issued in CA
Practice address
2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone
(909) 379-9794
NPI assigned
Oct 1, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA
Physician Assistant 363A00000X PA65348 CA Primary

Addresses

Primary practice location

2101 N Waterman Ave
San Bernardino, CA 92404-4836

Mailing address

152 E Hilton Ave
Redlands, CA 92373-6879
Phone (909) 379-9794

Other practice location 1

4371 Latham St
Riverside, CA 92501-1706
Phone (833) 867-4642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241231001316 CA Practitioner - Physician Assistant 6103353248 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborhood HealthcareGroup PAC ID 5294649406, 153 clinicians

Practice addresses (Care Compare)

1030 E Florida Ave
Hemet, CA 92543-4511
Phone (833) 867-4642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA65348CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Dec 1, 2024 Accepting new patients
Neighborhood Healthcare CurrentSince Sep 2, 2025 Accepting new patients
Neighborhood Healthcare CurrentSince Sep 2, 2025 Accepting new patients
Neighborhood Healthcare Past Accepting new patients
Neighborhood Healthcare PastSince Jan 1, 2021 Accepting new patients

Locations

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

425 N Date St
#0
Escondido, CA 92025

215 S Hickory St
Escondido, CA 92025
Phone (619) 354-3833

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4371 Latham St
Ste 200
Riverside, CA 92501

4371 Latham St
Riverside, CA 92501

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

41840 Enterprise Cir N
Temecula, CA 92590
Phone (951) 225-6400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1861210452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 E HILTON AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736879",
            "telephone_number": "909-379-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044836",
            "telephone_number": "909-379-9794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4371 Latham St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925011706",
            "country_code": "US",
            "telephone_number": "833-867-4642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YZAGUIRRE",
        "first_name": "BRADEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-01",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.