Basic Information
| Provider Information | |||||||||
| NPI: | 1376667568 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOLINA DE BRIONES | ||||||||
| FirstName: | DULCE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | ND, PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1300 AVENIDA VISTA HERMOSA STE 250 | ||||||||
| Address2: | |||||||||
| City: | SAN CLEMENTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926736340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9492402030 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1300 AVENIDA VISTA HERMOSA STE 250 | ||||||||
| Address2: | |||||||||
| City: | SAN CLEMENTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926736340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9492402030 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 11/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 11/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA19015 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 175F00000X | ND1213 | CA | Y | Other Service Providers | Naturopath |
ID Information
| ID | Type | State | Issuer | Description | ND1213 | 01 | CA | LICENSE | OTHER | PA19015 | 01 | CA | LICENSE | OTHER | 1075797 | 01 | CA | NCCPA CERTIFICATE # | OTHER |