Healthcare Provider Details

I. General information

NPI: 1679416341
Provider Name (Legal Business Name): VAUNSHAIE BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4909 E BALCH AVE APT 207
FRESNO CA
93727-8305
US

IV. Provider business mailing address

5377 N FRESNO ST STE 103
FRESNO CA
93710-6875
US

V. Phone/Fax

Practice location:
  • Phone: 925-278-9654
  • Fax: 925-278-9654
Mailing address:
  • Phone: 559-405-5602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: