Healthcare Provider Details

I. General information

NPI: 1629901160
Provider Name (Legal Business Name): BRANDON DEAN BAKER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 N BROOKHURST ST STE 130
ANAHEIM CA
92801-5618
US

IV. Provider business mailing address

421 N BROOKHURST ST STE 130
ANAHEIM CA
92801-5618
US

V. Phone/Fax

Practice location:
  • Phone: 714-831-1295
  • Fax: 714-984-0281
Mailing address:
  • Phone: 714-831-1295
  • Fax: 714-984-0281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: