Healthcare Provider Details

I. General information

NPI: 1275937989
Provider Name (Legal Business Name): LAURYN MICHELLE BRINK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2014
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26800 CROWN VALLEY PKWY STE 205
MISSION VIEJO CA
92691-6327
US

IV. Provider business mailing address

30230 RANCHO VIEJO RD STE 200
SAN JUAN CAPISTRANO CA
92675-1585
US

V. Phone/Fax

Practice location:
  • Phone: 805-456-6349
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95030725
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: