Healthcare Provider Details

I. General information

NPI: 1598313355
Provider Name (Legal Business Name): MARILYN D. BRAN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10155 COLIMA RD
WHITTIER CA
90603-2042
US

IV. Provider business mailing address

10954 GROVESIDE AVE
WHITTIER CA
90603-2833
US

V. Phone/Fax

Practice location:
  • Phone: 562-692-0383
  • Fax:
Mailing address:
  • Phone: 310-625-5376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number95550
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number123622
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: