Healthcare Provider Details

I. General information

NPI: 1932766466
Provider Name (Legal Business Name): MRS. MEGAN BREANNE CORNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS MEGAN BREANNE HASEBE

II. Dates (important events)

Enumeration Date: 05/20/2019
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 S CENTRAL ST
VISALIA CA
93277-4418
US

IV. Provider business mailing address

12231 AVENUE 322
VISALIA CA
93291-9243
US

V. Phone/Fax

Practice location:
  • Phone: 559-741-7358
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number133953
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number134502
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number90949
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: