Healthcare Provider Details

I. General information

NPI: 1710814157
Provider Name (Legal Business Name): M.I.R.N.A.A. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 S VAN NESS AVE
SANTA ANA CA
92707-2639
US

IV. Provider business mailing address

2019 S VAN NESS AVE
SANTA ANA CA
92707-3536
US

V. Phone/Fax

Practice location:
  • Phone: 657-669-8576
  • Fax:
Mailing address:
  • Phone: 657-669-8576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code246YC3301X
TaxonomyHospital Based Coding Specialist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. FRANCISCO DANIEL BRIZUELA
Title or Position: OWNER/FOUNDER/CEO
Credential: BS, ASMA, NCPT4
Phone: 657-669-8576