Provider Demographics
NPI:1194073312
Name:BROWN, BRENDA THINNES (MSPAS, MPH, PA-C)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:THINNES
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSPAS, MPH, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7525 LINDA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-5344
Mailing Address - Country:US
Mailing Address - Phone:858-650-3030
Mailing Address - Fax:
Practice Address - Street 1:7525 LINDA VISTA RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-5344
Practice Address - Country:US
Practice Address - Phone:858-650-3030
Practice Address - Fax:185-860-3033
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22305363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant