Individual
BREANNA VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19009 S LAUREL PARK RD SPC 24, COMPTON, CA 90220-6054
(310) 800-8475
Mailing address
19009 S LAUREL PARK RD SPC 24, COMPTON, CA 90220-6054
(310) 800-8475
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2471990
KAISER
CA
01
—
F1244657
KAISER
CA
Enumeration date
08/05/2020
Last updated
05/07/2025
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