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NPI Code Detail

MEDICARE: JAMES BRANDON MCKENNIE

MEDICARE: JAMES BRANDON MCKENNIE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1578412995
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES BRANDON MCKENNIE
Provider Business Mailing Address
First Line : 1130 3RD AVE APT 701
Second Line :
City : OAKLAND
State : CA
Zip : 94606-2202
Country : US
Telephone Number : 404-468-4117
Fax Number :
Provider Business Practice Location Address
First Line : 3301 E 12TH ST STE 259
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2940
Country : US
Telephone Number : 510-269-9030
Fax Number : 510-269-9031
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2026
Last Update Date : 01/30/2026

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Directions to “ JAMES BRANDON MCKENNIE ” Practice Location

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