MEDICARE: BROOKLYN RENEE' PAYTON MSW

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	1041C0700X	Clinical Social Worker	LCSW121939	CA

General Provider Information

NPI Number	:	1952013203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKLYN RENEE' PAYTON MSW

Provider Business Mailing Address
First Line	:	5630 VENICE BLVD # 1137
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-5127
Country	:	US
Telephone Number	:	323-412-9241
Fax Number	:

Provider Business Practice Location Address
First Line	:	5630 VENICE BLVD # 1137
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-5127
Country	:	US
Telephone Number	:	323-412-9241
Fax Number	:

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

Provider Enumeration Date	:	12/19/2022
Last Update Date	:	05/20/2026

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