Healthcare Provider Details

I. General information

NPI: 1518660372
Provider Name (Legal Business Name): ALISA E BREWSTER LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3211 COHASSET RD STE 130
CHICO CA
95973-5403
US

IV. Provider business mailing address

11073 FAITH RD
OROVILLE CA
95965-9729
US

V. Phone/Fax

Practice location:
  • Phone: 530-552-4627
  • Fax: 530-879-3823
Mailing address:
  • Phone: 151-087-5562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number212500
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: