Healthcare Provider Details

I. General information

NPI: 1992411672
Provider Name (Legal Business Name): BRANDON MEARS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10155 COLIMA RD
WHITTIER CA
90603-2042
US

IV. Provider business mailing address

6235 ROUNDHILL DR
WHITTIER CA
90601-3836
US

V. Phone/Fax

Practice location:
  • Phone: 562-692-0383
  • Fax:
Mailing address:
  • Phone: 562-321-7465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number138592
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: