Healthcare Provider Details

I. General information

NPI: 1326930090
Provider Name (Legal Business Name): YVETTE MICHELLE BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YVETTE MICHELLE KEENER

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2395 BECHELLI LN STE B
REDDING CA
96002-0156
US

IV. Provider business mailing address

3255 WINDING WAY
REDDING CA
96003-2206
US

V. Phone/Fax

Practice location:
  • Phone: 530-768-7397
  • Fax:
Mailing address:
  • Phone: 409-499-8875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-HIGDOJ
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: