MEDICARE: CECILIA BRAND

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
1	235Z00000X	Speech-Language Pathologist	38755	CA

General Provider Information

NPI Number	:	1790638062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILIA BRAND

Provider Business Mailing Address
First Line	:	333 S BEAUDRY AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-1466
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6055 CORONA AVE
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-3332
Country	:	US
Telephone Number	:	323-869-5920
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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Directions to “ CECILIA BRAND ” Practice Location

Language	Start Address	Practice Location

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