Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles Broadwater, RN

Individual provider Adult Psychiatric/Mental Health Registered Nurse · NPI 1043908163

Charles Broadwater, RN is an Adult Psychiatric/Mental Health Registered Nurse in San Diego, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2023
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

3853 Rosecrans St
San Diego, CA 92110-3115
Phone: (619) 692-8232
Fax: (619) 542-4060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Psychiatric/Mental Health Registered Nurse (primary) Taxonomy 163WP0809X · Licence 651695 (CA)

Record details

NPI number1043908163
Entity typeIndividual (Type 1)
GenderMale
Credentials RN
Sole proprietorYes
NPI enumeratedApril 26, 2023
Last updated in NPPESApril 26, 2023
Certification dateApril 26, 2023
Mailing address3853 Rosecrans St, San Diego, CA 92110-3115

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