Individual
BRETT A LONGACRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP, RN
Contact information
Practice address
427 S DATE ST, ESCONDIDO, CA 92025
(760) 212-3224
Mailing address
427 S DATE ST, ESCONDIDO, CA 92025
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
771286
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95003600
CA
Other
Enumeration date
10/26/2012
Last updated
04/13/2016
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