BREA DI DATO (NPI# 1770025959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770025959 |
| Entity Type | Individual |
| Full Name | BREA DI DATO |
| Credential | FNP, PMHNP |
| Practice Address |
1500 Sw Chandler Ave Bend OR 97702-3237 |
| Practice Telephone | 4155211506 |
| Practice Fax Number | 8774483551 |
| Mailing Telephone | 4155211506 |
| Mailing Fax Number | 8774483551 |
| Enumeration Date | 2016-11-05 |
| Last Update Date | 2020-04-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 201902570RN | OR | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | 709645 | CA | Nursing Service Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
201906949NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
95005877 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
202002414NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
NP95005877 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3081 Teagarden St, San Leandro, CA 945775720 | 5103474620 | |
| 582 Market St Ste 1608, San Francisco, CA 941045317 | 4155211506 | 8774483551 |
| Street Address |
1500 SW CHANDLER AVE |
| City | BEND |
| State | OR |
| Zip Code | 97702-3237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676259 | Amy Michelle Anderson | Counselor | 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 | 2020-10-15 |
| 1386259463 | Jacob Rehder | Counselor | 19717 Mt Batchelor Dr, #226, Bend, OR 97702 | 2020-09-15 |
| 1497385215 | Capacity Performance Therapy | Physical Medicine & Rehabilitation | 61125 Lodgepole Dr., Bend, OR 97702 | 2020-01-21 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1609435049 | Praxis Medical Group Inc | Orthopaedic Surgery | 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 | 2019-06-10 |
| 1013485754 | Elana Leah Pesah | Social Worker | 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 | 2018-11-12 |
| 1104303239 | Kyleigh Mcvey | Massage Therapist | 999 Sw Disk Dr, Bend, OR 97702 | 2018-07-21 |
| 1477042869 | Siloe Castaneda Huerta | Counselor | 1340 Nw Wall, Bend, Or, Bend, OR 97702 | 2018-05-02 |
| 1164910808 | Rebecca M Joyce | Social Worker | 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 | 2018-04-27 |
| 1093217978 | Jennifer Bury | Acupuncturist | 296 Sw Columbia St Ste D1, Bend, OR 97702 | 2018-03-06 |
| Find all providers in zip 97702 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578934535 | Kimberly Sue Butler | Nurse Practitioner | 339 Sw Century Dr Ste 101, Bend, OR 97702-1199 | 2015-10-15 |
| 1528317898 | Kara Lynn Kelly | Nurse Practitioner | 339 Sw Century Dr, Suite 101, Bend, OR 97702-1198 | 2012-09-02 |
| 1114273711 | Deborah Macwilliams | Nurse Practitioner | 731 Nw Franklin Ave Ste 104, Bend, OR 97703 | 2012-08-01 |
| 1801122668 | Kay Oliver | Nurse Practitioner | 1010 Nw Harriman St, Suite A, Bend, OR 97701-1912 | 2009-10-28 |
| 1699906305 | Kristin Brooks | Nurse Practitioner | 336 Ne Norton Ave. Ste. 3, Bend, OR 97701-3598 | 2009-07-29 |
| 1003071499 | Nicholas J Campo IIi | Nurse Practitioner | 233 Sw Wilson Ave Ste 201, Bend, OR 97702-2988 | 2008-07-24 |
| 1922180777 | Deborah Padgett Coehlo | Nurse Practitioner | 62930 O B Riley Rd Ste 300, Bend, OR 97703-9459 | 2006-10-20 |
| 1033718242 | Hagen Psychiatry LLC | Nurse Practitioner | 2955 N Highway 97 Ste 100, Bend, OR 97703-7559 | 2020-10-19 |
| 1235766510 | Richard Dean Akers | Nurse Practitioner | 2577 Ne Courtney Dr, Bend, OR 97701-7752 | 2020-03-25 |
| 1952854481 | Kara Kelly, LLC | Nurse Practitioner | 2955 N Hwy 97, Suite 102, Bend, OR 97703-7559 | 2016-08-02 |
| Find all providers in BEND | ||||
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| 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.