Kevin Josiah Brink

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3100 S Harbor Blvd
Suite 200
Santa Ana, CA 92704-6823

Phone

(714) 966-8650

NPI assigned

Apr 17, 2008

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 17, 2008.

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1992979173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 S HARBOR BLVD",
            "address_2": "SUITE 200",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046823",
            "telephone_number": "714-966-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 S HARBOR BLVD",
            "address_2": "SUITE 200",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046823",
            "telephone_number": "714-966-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINK",
        "first_name": "KEVIN",
        "middle_name": "JOSIAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Santa Ana, CA
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.