Healthcare Provider Details

I. General information

NPI: 1740107093
Provider Name (Legal Business Name): BRIANNA LILI CARRANZA MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1895 ORANGE TREE LN STE 102
REDLANDS CA
92374-0112
US

IV. Provider business mailing address

1895 ORANGE TREE LN STE 102
REDLANDS CA
92374-0112
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-2500
  • Fax: 909-651-8796
Mailing address:
  • Phone: 909-558-2500
  • Fax: 909-651-8796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41496
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: