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General NPI Number Information
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NPI Number | 1386395762
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Entity Type | Individual
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Provider Name | ALEX BRANDON CAPUCHINO DNP
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Gender | Male
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Dates
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Enumeration Date | 01/17/2022
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 570 W 4TH ST STE 206
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City | SAN BERNARDINO
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State | CA
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Zip | 92401-1438
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Country | US
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Telephone | 760-260-8602
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Fax |
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Provider Business Mailing Address
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Address Line | 36622 BAY HILL DR
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City | BEAUMONT
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State | CA
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Zip | 92223-8021
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Country | US
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Telephone | 951-453-0717
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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 | NP95026301
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 95137939
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License Number State | CA
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