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General NPI Number Information
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NPI Number | 1205104726
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Entity Type | Individual
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Provider Name | MONA RAE BREID NP-C
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Gender | Female
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Dates
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Enumeration Date | 12/12/2011
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 24910 LAS BRISAS RD STE 106
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City | MURRIETA
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State | CA
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Zip | 92562-4010
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Country | US
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Telephone | 888-380-0401
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Fax |
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Provider Business Mailing Address
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Address Line | 38718 CELITA CIR
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City | TEMECULA
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State | CA
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Zip | 92592-8576
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Country | US
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Telephone | 951-775-0803
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F0911050
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 264649
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License Number State | CA
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