Provider Demographics
NPI:1871250415
Name:CAMPBELL, BROOKE (ND)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4729 ROBBINS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-3036
Mailing Address - Country:US
Mailing Address - Phone:480-309-9380
Mailing Address - Fax:
Practice Address - Street 1:124 LOMAS SANTA FE DR STE 206
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1252
Practice Address - Country:US
Practice Address - Phone:858-228-4188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1276175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath