Braincom Advanced Nursing Corporation

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

BRAINCOM ADVANCED NURSING CORPORATION

Practice address

1003 E Cooley Dr Ste 211
Colton, CA 92324-3907

Phone

(951) 545-1149

NPI assigned

Aug 11, 2023

Last updated

Jul 29, 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

Nelly Duarti, PMHNPNPI 1487000683

Title

Pmhnp

Phone

(951) 545-1149

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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.

• Nelly Duarti, R.N.

  • Psychiatric/Mental Health Nurse Practitioner
  • Chino, CA
  • NPI 1487000683

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1982387221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 N MAIN ST # 131-B17",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928781440",
            "telephone_number": "951-545-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 E COOLEY DR STE 211",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243907",
            "telephone_number": "951-545-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAINCOM ADVANCED NURSING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-11",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "DUARTI",
        "authorized_official_first_name": "NELLY",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "951-545-1149",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zayne Edward Boudreauxramirez
• Katherine Elizabeth Bourbeau-Medinilla, MD
• Nina Nicole Bowman, D.O.
• Farshid Bozorgnia, MD
• Andreniki Bradbury
• Brandon J Inc
• Brandon J Inc/Serenity Place
• Brandon J Inc/Serenity Place
• Theresa Christine Brandon, MS, LMFT
• Preciosa M Brandow, M.S,, PPS

• Psychiatric/Mental Health Nurse Practitioner in Colton, CA
• Providers in Colton, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.