Healthcare Provider Details

I. General information

NPI: 1295625390
Provider Name (Legal Business Name): KARINA BIANCA BRAMBILA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 LOMALAND DR
SAN DIEGO CA
92106-2899
US

IV. Provider business mailing address

2888 IRIS AVE SPC 106
SAN DIEGO CA
92154-3351
US

V. Phone/Fax

Practice location:
  • Phone: 619-849-2200
  • Fax:
Mailing address:
  • Phone: 619-616-9758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: