Healthcare Provider Details

I. General information

NPI: 1346801388
Provider Name (Legal Business Name): BREANN GARCIA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BREANN KINSEY PA-C

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 06/24/2021
Certification Date: 06/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E ROMIE LN STE K
SALINAS CA
93901-4031
US

IV. Provider business mailing address

22590 MURIETTA RD
SALINAS CA
93908-9696
US

V. Phone/Fax

Practice location:
  • Phone: 831-422-9066
  • Fax:
Mailing address:
  • Phone: 503-510-6783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA56797
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: