Provider Demographics
NPI:1033838339
Name:BALDWIN, BRIANNA JARAMILLO (ACNP)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:JARAMILLO
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7720 FAY AVE
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4309
Mailing Address - Country:US
Mailing Address - Phone:858-454-2700
Mailing Address - Fax:858-454-2782
Practice Address - Street 1:7720 FAY AVE
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4309
Practice Address - Country:US
Practice Address - Phone:858-454-2700
Practice Address - Fax:858-454-2782
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95068766163W00000X
CA95021279363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse