Healthcare Provider Details

I. General information

NPI: 1447126131
Provider Name (Legal Business Name): BRIANNA NICOLE ALONSO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 W CREST ST STE 100
ESCONDIDO CA
92025-1735
US

IV. Provider business mailing address

750 N KIRBY ST APT 8DD
HEMET CA
92545-1902
US

V. Phone/Fax

Practice location:
  • Phone: 760-744-3672
  • Fax:
Mailing address:
  • Phone: 951-925-9814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberR1478140822
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: