Provider Demographics
NPI:1114982048
Name:BRIGNONI, CATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:BRIGNONI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 626
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-0626
Mailing Address - Country:US
Mailing Address - Phone:760-340-4300
Mailing Address - Fax:760-340-4322
Practice Address - Street 1:72670 FRED WARING DR STE 202
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-5013
Practice Address - Country:US
Practice Address - Phone:760-340-4300
Practice Address - Fax:760-340-4322
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20210504422084N0400X
VA01012415852084N0400X
IL0361130192084N0400X
CAA968022084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036113019Medicaid
MO200106554Medicaid
CAA96802OtherSTATE MEDICAL LICENSE
I27407Medicare UPIN
IL036113019Medicaid