Provider Demographics
NPI:1629780622
Name:BRAZIER, BREANNA MONE (DOULA/ CLE)
Entity Type:Individual
Prefix:
First Name:BREANNA MONE
Middle Name:
Last Name:BRAZIER
Suffix:
Gender:F
Credentials:DOULA/ CLE
Other - Prefix:
Other - First Name:BREANNA
Other - Middle Name:MONE
Other - Last Name:BRAZIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DOULA/ CLE
Mailing Address - Street 1:21185 MARKHAM ST
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-8888
Mailing Address - Country:US
Mailing Address - Phone:323-470-4286
Mailing Address - Fax:
Practice Address - Street 1:21185 MARKHAM ST
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-8888
Practice Address - Country:US
Practice Address - Phone:323-470-4286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC67D661A5374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula