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General NPI Number Information
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NPI Number | 1306730148
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Entity Type | Individual
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Provider Name | HENRY LOUIS BRUNEEL PMHNP
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Gender | Male
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 28359 WELFLEET LANE HOME
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City | SANTA CLARITA
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State | CA
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Zip | 91350
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Country | US
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Telephone | 920-213-0401
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Fax |
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Provider Business Mailing Address
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Address Line | 28359 WELFLEET LANE HOME
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City | SANTA CLARITA
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State | CA
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Zip | 91350
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Country | US
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Telephone | 920-213-0401
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 772079
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License Number State | CA
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