Healthcare Provider Details

I. General information

NPI: 1194955930
Provider Name (Legal Business Name): SARAH MARGARET BRANT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 NEILSON ST STE 125
WATSONVILLE CA
95076-2491
US

IV. Provider business mailing address

65 NEILSON ST STE 102
WATSONVILLE CA
95076-2491
US

V. Phone/Fax

Practice location:
  • Phone: 831-768-6266
  • Fax:
Mailing address:
  • Phone: 831-768-6266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberP6787
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA163294
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: