Provider Demographics
NPI:1518587054
Name:BROWN, SUMMER (PMHNP-BC, MSN)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:PMHNP-BC, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24351 REGINA ST
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-4714
Mailing Address - Country:US
Mailing Address - Phone:714-655-3365
Mailing Address - Fax:949-541-6463
Practice Address - Street 1:24351 REGINA ST
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-4714
Practice Address - Country:US
Practice Address - Phone:714-655-3365
Practice Address - Fax:949-541-6463
Is Sole Proprietor?:No
Enumeration Date:2020-04-24
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016588363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health