Individual provider · NPI-1

Grace Breault, NP

Nurse Practitioner · Mountain View, CA

NPI number1497739585
StatusActive
Last updated in NPPESMar 14, 2016

Details

NPI
1497739585
Entity type
Individual (NPI-1)
Name
Grace Breault
Credential
NP
Sex
Female
Sole proprietor
No
Enumeration date
Dec 1, 2005
Last updated
Mar 14, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse PractitionerNP8263CAYes
163WD0400X Registered Nurse, Diabetes EducatorNP8263CA

Practice location

701 E El Camino Real
Mountain View, CA 94040-2833

Phone 650-934-7177

Mailing address

2350 W. El Camino Real
2nd Floor
Mountain View, CA 94040-6203

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