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NPI Code Detail

MEDICARE: ADRIENNE ROSE BRAZAS

MEDICARE: ADRIENNE ROSE BRAZAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1164100749
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIENNE ROSE BRAZAS
Provider Business Mailing Address
First Line : PO BOX 33568
Second Line :
City : SAN DIEGO
State : CA
Zip : 92163-3568
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Provider Business Practice Location Address
First Line : 9129 ELK GROVE BLVD
Second Line :
City : ELK GROVE
State : CA
Zip : 95624-2012
Country : US
Telephone Number : 855-223-7123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2023
Last Update Date : 09/05/2025

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Directions to “ ADRIENNE ROSE BRAZAS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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