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NPI Code Detail

MEDICARE: REBECCA BRANCH

MEDICARE: REBECCA BRANCH
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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1710533294
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA BRANCH
Provider Business Mailing Address
First Line : 16782 VON KARMAN AVE STE 11
Second Line :
City : IRVINE
State : CA
Zip : 92606-2417
Country : US
Telephone Number : 949-833-2237
Fax Number :
Provider Business Practice Location Address
First Line : 1425 N MCDOWELL BLVD STE 206
Second Line :
City : PETALUMA
State : CA
Zip : 94954-6525
Country : US
Telephone Number : 855-223-7123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2019
Last Update Date : 06/06/2023

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Directions to “ REBECCA BRANCH ” Practice Location

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