Healthcare Provider Details

I. General information

NPI: 1528881703
Provider Name (Legal Business Name): JARRETT TREANDUS BRANCH JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 PLACER ST
REDDING CA
96001-1734
US

IV. Provider business mailing address

1147 HARTNELL AVE
REDDING CA
96002-2113
US

V. Phone/Fax

Practice location:
  • Phone: 530-223-2822
  • Fax:
Mailing address:
  • Phone: 530-222-7213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: