Provider Demographics
NPI:1700687746
Name:CHAMPION HEALTH & WELLNESS FUNCTIONAL NURSING, P.C.
Entity type:Organization
Organization Name:CHAMPION HEALTH & WELLNESS FUNCTIONAL NURSING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BREANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMPION-YBARRA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:888-569-1442
Mailing Address - Street 1:2618 SAN MIGUEL DR # 2044
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5437
Mailing Address - Country:US
Mailing Address - Phone:888-569-1442
Mailing Address - Fax:
Practice Address - Street 1:23792 ROCKFIELD BLVD SUITE 285
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630
Practice Address - Country:US
Practice Address - Phone:888-569-1442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care