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General NPI Number Information
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NPI Number | 1184209280
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Entity Type | Individual
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Provider Name | BRANDON INOSTROZA SLPA
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Gender | Male
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 2851 S LA CADENA DR SPC 56
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City | COLTON
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State | CA
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Zip | 92324-3811
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Country | US
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Telephone | 909-362-6344
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Fax |
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Provider Business Mailing Address
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Address Line | 6800 BROCKTON AVE
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City | RIVERSIDE
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State | CA
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Zip | 92506-3835
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 6481
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License Number State | CA
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