Healthcare Provider Details

I. General information

NPI: 1366907305
Provider Name (Legal Business Name): JAMES STEPHEN BRINKMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: STEVE BRINKMAN

II. Dates (important events)

Enumeration Date: 02/04/2019
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 N SUNRISE WAY
PALM SPRINGS CA
92262-5201
US

IV. Provider business mailing address

191 N SUNRISE WAY
PALM SPRINGS CA
92262-5201
US

V. Phone/Fax

Practice location:
  • Phone: 760-770-2286
  • Fax:
Mailing address:
  • Phone: 760-770-2286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberC053480518
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC053480518
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: