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NPI Code Detail

MEDICARE: MISS BREANNA NICOLE DONALDSON

MEDICARE: MISS BREANNA NICOLE DONALDSON
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
1101Y00000XCounselor
21041C0700XClinical Social Worker129708CA
3390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1518431295
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS BREANNA NICOLE DONALDSON
Provider Business Mailing Address
First Line : 1108 BISSELL AVE
Second Line :
City : RICHMOND
State : CA
Zip : 94801-3135
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1108 BISSELL AVE
Second Line :
City : RICHMOND
State : CA
Zip : 94801-3135
Country : US
Telephone Number : 510-307-4589
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2019
Last Update Date : 03/03/2026

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Directions to “ MISS BREANNA NICOLE DONALDSON ” Practice Location

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