Healthcare Provider Details

I. General information

NPI: 1831004266
Provider Name (Legal Business Name): AEXA MICHELLE BRANCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17752 SKY PARK CIR STE 140
IRVINE CA
92614-4469
US

IV. Provider business mailing address

9851 SMOKEWOOD DR
VILLA PARK CA
92861-1203
US

V. Phone/Fax

Practice location:
  • Phone: 949-474-5577
  • Fax: 949-475-5575
Mailing address:
  • Phone: 949-474-5577
  • Fax: 949-475-5575

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: