Healthcare Provider Details

I. General information

NPI: 1952228314
Provider Name (Legal Business Name): BREANNA LYNN ENTZ CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 POLK ST UNIT 221
REDDING CA
96001-3553
US

IV. Provider business mailing address

2950 POLK ST UNIT 221
REDDING CA
96001-3553
US

V. Phone/Fax

Practice location:
  • Phone: 530-356-4344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: