Individual
MS. BROOKE NYCOLE ATILANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2731 NUGGET AVE, LAKE ISABELLA, CA 93240-9456
(760) 463-5027
(760) 379-5332
Mailing address
2731 NUGGET AVE, LAKE ISABELLA, CA 93240-9456
(760) 463-5027
(760) 379-5332
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
D5170094
CA
175T00000X
Peer Specialist
Primary
MPSS-DXFPLC
CA
175T00000X
Peer Specialist
—
—
Other
Enumeration date
04/05/2023
Last updated
02/08/2024
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