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NPI Code Detail

MEDICARE: BRANDON WAUTLET

MEDICARE:   BRANDON  WAUTLET
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
1101YM0800XMental Health Counselor7025621735CA

General Provider Information

NPI Number : 1861360596
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDON WAUTLET
Provider Business Mailing Address
First Line : 5741 ARROWHEAD DR
Second Line :
City : FORESTHILL
State : CA
Zip : 95631-9604
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11080 B AVE
Second Line :
City : AUBURN
State : CA
Zip : 95603-2618
Country : US
Telephone Number : 530-886-3470
Fax Number : 530-886-3472
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2025
Last Update Date : 10/24/2025

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Directions to “ BRANDON WAUTLET ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.