Active NPI
Brenae Zanders
- Student in an Organized Health Care Education/Training Program
- Redding, CA
National Provider Identifier
1902315039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 4625 Mountain Lakes Blvd
Redding, CA 96003-1450 - Phone
- (323) 373-2400
- NPI assigned
- Sep 20, 2017
- Reactivated
- Sep 11, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 94019 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
4625 Mountain Lakes Blvd
Redding, CA 96003-1450
Mailing address
4625 Mountain Lakes Blvd
Redding, CA 96003-1450
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94019 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726444800000",
"number": "1902315039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4625 MOUNTAIN LAKES BLVD",
"city": "REDDING",
"state": "CA",
"postal_code": "960031450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4625 MOUNTAIN LAKES BLVD",
"city": "REDDING",
"state": "CA",
"postal_code": "960031450",
"telephone_number": "323-373-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZANDERS",
"first_name": "BRENAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-20",
"last_updated": "2024-09-16",
"certification_date": "2024-09-16",
"deactivation_date": "2024-07-01",
"reactivation_date": "2024-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "94019",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.