Healthcare Provider Details

I. General information

NPI: 1568318707
Provider Name (Legal Business Name): MYRNA BRIONES BAGAOISAN-ASUNCION RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1904 RICHLAND AVE
CERES CA
95307-4562
US

IV. Provider business mailing address

1904 RICHLAND AVE
CERES CA
95307-4562
US

V. Phone/Fax

Practice location:
  • Phone: 209-525-5079
  • Fax:
Mailing address:
  • Phone: 209-525-5079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number539980
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: