MEDICARE: MISS KASANDRA BRAVO III

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1366813891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KASANDRA BRAVO III

Provider Business Mailing Address
First Line	:	4210 BORRA CT
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056
Country	:	US
Telephone Number	:	760-917-0958
Fax Number	:

Provider Business Practice Location Address
First Line	:	4210 BORRA CT
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-3461
Country	:	US
Telephone Number	:	760-917-0958
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2015
Last Update Date	:	10/09/2015

Similar Medicare Providers

1841077542 — BROOKE LANDRY PA-C
Practice Location Address:

3998 VISTA WAY STE 202
OCEANSIDE, CA
92056-4518

Practice Phone: 760-736-6767
Practice Fax:

1619832326 — ELSIE ROSS MEDICAL CORPORATION
Practice Location Address:

3601 VISTA WAY STE 203
OCEANSIDE, CA
92056-4559

Practice Phone: 760-724-5352
Practice Fax:

1356206890 — THE FAIRY TOX-MOTHER INC.
Practice Location Address:

2401 VISTA WAY , SUITE A
OCEANSIDE, CALIFORNIA
92056

Practice Phone:
Practice Fax:

1174286223 — MEGAN KRISTINA FONDREN LCSW
Practice Location Address:

1300 RANCHO DEL ORO RD
OCEANSIDE, CA
92056-1729

Practice Phone: 404-317-1573
Practice Fax:

1114400967 — MARILYNN M. SHAW MS, APRN, NP, CNS
Practice Location Address:

3927 WARING RD STE C
OCEANSIDE, CA
92056-4458

Practice Phone: 619-703-7220
Practice Fax:

1235944026 — ANGELICA SANTIAGO
Practice Location Address:

4055 OCEANSIDE BLVD STE T
OCEANSIDE, CA
92056-5821

Practice Phone: 949-474-1493
Practice Fax:

Directions to “ MISS KASANDRA BRAVO III ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.