KELCIE PINICK BRAGG


Address: 2093 Swan Dr, Costa Mesa, CA 92626-4765
Phone: 7142227824

KELCIE PINICK BRAGG (NPI# 1912447624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912447624
Entity Type Individual
Full Name KELCIE PINICK BRAGG
Credential DNP, CPNP-AC
Practice Address 2093 Swan Dr
Costa Mesa
CA 92626-4765
Practice Telephone 7142227824
Mailing Telephone 7142227824
Enumeration Date 2017-02-28
Last Update Date 2020-08-14
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0222X Nurse Practitioner
Specialization: Pediatrics, Critical Care
95006241 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 2093 SWAN DR
City COSTA MESA
State CA
Zip Code 92626-4765

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1215536982 Sergio Gutierrez Behavior Technician 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 2020-10-22
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1265071096 Austin Stotelmyre Behavior Technician 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 2019-12-26
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1851933550 Jennifer Rivera Behavior Technician 1111 Baker St. Unit #a, Costa Mesa, CA 92626 2019-10-14
1962053595 Peter Na Behavior Technician Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 2019-09-25
1346897147 Jennifer Lopez Behavior Technician 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 2019-08-26
1679134084 Danny Garcia Chiropractic, PC Chiropractor 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 2019-06-26
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Taxonomy Information

Taxonomy Code 363LP0222X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics, Critical Care

Taxonomy Definition

Definition to come...

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1992223069 Ambili N Thannil Nurse Practitioner 550 16th Street 5th Floor, San Francisco, CA 94158 2017-09-08
1568987261 Janna Alene Bennett Nurse Practitioner 67 Yolanda Dr, San Anselmo, CA 94960 2017-08-03
1639623630 Sarah Meyer Nurse Practitioner 1326 Amherst Ave Apt 5, Los Angeles, CA 90025-2056 2016-08-08
1205299187 Alice Rachel Parker Nurse Practitioner 1975 4th Street, Box 550, Ucsf Benioff Children's Hospital, San Francisco, CA 94158-2351 2016-03-30
1952643579 Denise Colleen Schiel Nurse Practitioner 3030 Childrens Way Ste 115, San Diego, CA 92123-4226 2013-03-21
1093095028 Meredith M Lahey Nurse Practitioner 77 Paseo Mirasol, Tiburon, CA 94920-2079 2011-08-22
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Competitor

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City COSTA MESA
Zip Code 92626

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Dataset Information

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.

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