Provider Demographics
NPI:1710562319
Name:ABRIFOR, BREANA (LVN)
Entity Type:Individual
Prefix:
First Name:BREANA
Middle Name:
Last Name:ABRIFOR
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 1:1521 W AVENUE J8 APT 261
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-1220
Mailing Address - Country:US
Mailing Address - Phone:323-949-0669
Mailing Address - Fax:
Practice Address - Street 1:1521 W AVENUE J8 APT 261
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-1220
Practice Address - Country:US
Practice Address - Phone:323-949-0669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA714573164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse