Provider Demographics
NPI:1265003339
Name:BRAULIO, GILBERT ROGACION (PHN, RN)
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:ROGACION
Last Name:BRAULIO
Suffix:
Gender:M
Credentials:PHN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12473 HEATHERTON CT APT 329
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-5190
Mailing Address - Country:US
Mailing Address - Phone:619-341-9803
Mailing Address - Fax:
Practice Address - Street 1:12473 HEATHERTON CT APT 329
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-5190
Practice Address - Country:US
Practice Address - Phone:619-341-9803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA561782163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health