Breanna Odneal

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

1950 Parallel Dr
Lakeport, CA 95453-9388

Phone

(707) 263-3949

NPI assigned

Sep 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Easter Seals Bay Area

  • Early Intervention Provider Agency
  • Lakeport, CA
  • NPI 1427526847
  NPD (past)

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1992584866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 SHADELANDS DR BLDG 10",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 PARALLEL DR",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954539388",
            "telephone_number": "707-263-3949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Mason St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Ukiah",
            "state": "CA",
            "postal_code": "954824483",
            "country_code": "US",
            "telephone_number": "707-463-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODNEAL",
        "first_name": "BREANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-28",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern California Medical Assoc Inc
• Northern California Medical Assoc Inc
• Northlake Internal Medicine
• Linda R Norton
• Barbara Nuckols, MA
• Joanna A Ortiz Prado
• Patrick Robert Ostrander, L.P.T.
• Socorro Rocha Padilla, LCSW-78088
• Sunny Park, DMD
• Parkview Podiatry

• Specialist in Lakeport, CA
• Providers in Lakeport, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.