DARRELL BROUSSARD NPI 1699616516

NPI Information

  • NPI: 1699616516
  • Provider Name: DARRELL BROUSSARD
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • Address: 7898 PORTOFINO ST
    HIGHLAND, CA
    ZIP 92346
  • Phone: (909) 327-7284

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NPI Details

Darrell Broussard is a psychiatric/mental health nurse practitioner in Highland, CA. Darrell Broussard NPI is 1699616516. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7898 PORTOFINO ST
HIGHLAND, CA
ZIP 92346-378
Phone: (909) 327-7284

The enumeration date for this NPI number is 4/3/2026 and was last updated on 4/3/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health95038413CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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