Individual
ADAM BRASKET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
5475 E LA PALMA AVE, ANAHEIM, CA 92807-2075
(949) 333-5226
(949) 579-9102
Mailing address
11704 ETON DR, GRAND TERRACE, CA 92313-5125
(618) 401-6468
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
743355
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95015268
CA
Other
Enumeration date
04/22/2020
Last updated
09/24/2020
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