Healthcare Provider Details

I. General information

NPI: 1568933653
Provider Name (Legal Business Name): GIOVANA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 BAKER ST
COSTA MESA CA
92626-4138
US

IV. Provider business mailing address

206 N JACKSON ST STE 202
GLENDALE CA
91206-4330
US

V. Phone/Fax

Practice location:
  • Phone: 818-241-6780
  • Fax: 818-241-6853
Mailing address:
  • Phone: 818-241-6780
  • Fax: 818-241-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number005096-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: