Healthcare Provider Details

I. General information

NPI: 1942357728
Provider Name (Legal Business Name): NICHOLAS BRANDON HOUSTON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17337 VENTURA BLVD STE 330
ENCINO CA
91316-3903
US

IV. Provider business mailing address

1000 PASEO CAMARILLO STE 130
CAMARILLO CA
93010-0748
US

V. Phone/Fax

Practice location:
  • Phone: 818-788-2884
  • Fax: 818-788-0507
Mailing address:
  • Phone: 805-644-0461
  • Fax: 818-788-0507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number16415
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: