Provider Demographics
NPI:1548917248
Name:BRIZUELA, ADRIENNE ALEXANDRA
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:ALEXANDRA
Last Name:BRIZUELA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 MILL ST STE A
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1696
Mailing Address - Country:US
Mailing Address - Phone:775-343-9260
Mailing Address - Fax:
Practice Address - Street 1:855 MILL ST STE A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1696
Practice Address - Country:US
Practice Address - Phone:775-343-9260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty