Patricio and Sandra Bracero Haven, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PATRICIO AND SANDRA BRACERO HAVEN, INC

Practice address

15475 Seneca Rd Ste B
Victorville, CA 92392-2299

Phone

(702) 493-7831

Fax

(760) 493-2875

NPI assigned

Apr 13, 2023

Last updated

Oct 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carol P MartinezNPI 1396166450

Title

Ceo

Phone

(760) 493-7831

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carol Martinez

  • Social Worker
  • Inglewood, CA
  • NPI 1396166450
  NPD Authorized official

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1912693904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15475 SENECA RD STE B",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922299",
            "telephone_number": "702-493-7831",
            "fax_number": "760-493-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15475 SENECA RD STE B",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922299",
            "telephone_number": "702-493-7831",
            "fax_number": "760-493-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIO AND SANDRA BRACERO HAVEN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-13",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-493-7831"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priyanki Rahul Patel, PHARM.D
• Ravi Patel, DPT
• Shailja J Patel, PT
• Vrunda K Patel, PHARM D
• Tanya Patimeteeporn, MSW
• Angela Patrick
• Jada Patterson
• Kevon D Patterson, ACSW
• Nicole Patterson
• Rechelle Patterson, DOULA

• Home Health Agency in Victorville, CA
• Providers in Victorville, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.

Verify at the official NPI Registry.