Provider Demographics
NPI:1013636505
Name:BREWER, JEANNETTE ANN (LVN)
Entity Type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:ANN
Last Name:BREWER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:40925 COUNTY CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-6037
Mailing Address - Country:US
Mailing Address - Phone:951-600-6300
Mailing Address - Fax:951-600-6377
Practice Address - Street 1:40925 COUNTY CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-6037
Practice Address - Country:US
Practice Address - Phone:951-600-6300
Practice Address - Fax:951-600-6377
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA23749364SP0809X, 164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult