MR. JOHN ROBERT BROUSSARD (NPI# 1013271196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013271196 |
| Entity Type | Individual |
| Full Name | MR. JOHN ROBERT BROUSSARD |
| Practice Address |
2711 Edgewood Dr Placerville CA 95667-3409 |
| Practice Telephone | 5303061816 |
| Mailing Telephone | 5303061816 |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2012-07-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174839161 | John Broussard | Family Medicine | 111 2nd Ave Ne Ste 1401, St Petersburg, FL 33701-3480 | 2010-08-27 |
| 1750696639 | John Edward Broussard | Pharmacist | 105 Cities Service Hwy, Sulphur, LA 70663-5419 | 2010-08-16 |
| 1326509977 | John Broussard | Student in an Organized Health Care Education/Training Program | 1430 Tulane Ave # 8679, New Orleans, LA 70112-2632 | 2019-03-27 |
| 1033645494 | John Joseph Broussard | Physical Therapist | 2115 Dulles Dr, Lafayette, LA 70506-2652 | 2017-05-04 |
| 1063648889 | John Broussard | Physical Therapist | 620 N Morrison Blvd Ste G, Hammond, LA 70401-2312 | 2009-06-08 |
| 1548462898 | John Broussard | Physical Therapist | 4412 N Davis Hwy, Pensacola, FL 32503-2756 | 2007-05-31 |
| 1992844476 | John King Broussard | Psychologist | 1600 Airport Fwy, Suite 322, Bedford, TX 76022-6850 | 2007-02-05 |
| Street Address |
2711 EDGEWOOD DR |
| City | PLACERVILLE |
| State | CA |
| Zip Code | 95667-3409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053919258 | Lacey Etienne Neufeld | Nurse Practitioner | Marshall Transitional Care Unit, 1100 Marshall Way, Placerville, CA 95667 | 2020-10-12 |
| 1497390041 | Summitview Child & Family Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3025 Glee Ln, Placerville, CA 95667 | 2019-11-07 |
| 1225694474 | Camille Borba | Doula | 1212 Lotus Rd, Placerville, CA 95667 | 2019-05-14 |
| 1033610399 | Julie Marie Halsall | Counselor | 2844 Coloma Street, Placerville, CA 95667 | 2018-02-22 |
| 1053839092 | County of El Dorado | Community/Behavioral Health | 3057 Briw Road, Suite A, Placerville, CA 95667 | 2017-08-30 |
| 1982129508 | Brent Charles Ulrici | Counselor | 2986 Colma St, Placerville, CA 95667 | 2017-08-04 |
| 1629464326 | Crystal Coury | Counselor | 5607 Mount Murphy Roas, Garden Valley, CA 95667 | 2015-04-09 |
| 1396141750 | Brown and Ghazal Dental Corporation | Dentist | 3967 Missouri Flat Road, Suite 120, Placerville, CA 95667 | 2014-11-13 |
| 1962808402 | Laura Ann Curry | Counselor | 6765 Green Valley Road, Placerville, CA 95667 | 2014-11-11 |
| 1518374453 | Kelly Lynn Carson | Counselor | 2844 Colona St., Placerville, CA 95667 | 2014-07-11 |
| Find all providers in zip 95667 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386208833 | Gail Elizabeth Healy | Counselor | 438 Main St Ste C, Placerville, CA 95667-5648 | 2019-04-30 |
| 1881186542 | Theresa Del Biaggio | Counselor | 2864 Ray Lawyer Dr Ste 209, Placerville, CA 95667-3937 | 2018-05-30 |
| 1750770954 | Ilona Alexandra Munzer | Counselor | 6765 Green Valley Rd # D, Placerville, CA 95667-8984 | 2015-01-12 |
| 1427446947 | Alexandra Ivanovsky | Counselor | 1166 Broadway, Ste N, Placerville, CA 95667-5729 | 2015-01-06 |
| 1528364114 | Crystal Cochran | Counselor | 4300 Forni Rd, Placerville, CA 95667-7013 | 2011-01-31 |
| 1649598160 | Amy Lykes | Counselor | 670 Placerville Drive, Suite 2, Placerville, CA 95667 | 2010-05-07 |
| 1003050543 | Meghan Jones | Counselor | 935b Spring Street, Placerville, CA 95667 | 2009-04-28 |
| 1184877979 | Nicole Riley | Counselor | 211 New Morning Ct, Placerville, CA 95667-5446 | 2008-10-24 |
| 1871755108 | Maureen Adele Focht | Counselor | 2808 Mallard Ln # C, Placerville, CA 95667-8770 | 2008-06-27 |
| 1912185646 | Julia B Vanderschaaf | Counselor | 550 Main St Ste B1b, Placerville, CA 95667-5634 | 2008-02-05 |
| Find all providers in PLACERVILLE | ||||
| City | PLACERVILLE |
| Zip Code | 95667 |
Please comment or provide details below to improve the information on MR. JOHN ROBERT BROUSSARD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.