Provider Demographics
NPI:1275878407
Name:BRINKMANN, ALICE INA (LVN)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:INA
Last Name:BRINKMANN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 KALMUS DR STE K3
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5975
Mailing Address - Country:US
Mailing Address - Phone:714-384-3870
Mailing Address - Fax:
Practice Address - Street 1:151 KALMUS DR STE K3
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5975
Practice Address - Country:US
Practice Address - Phone:714-384-3870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator