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General NPI Number Information
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NPI Number | 1407765274
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Entity Type | Individual
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Provider Name | TASHA LATRECE BROWN ASW128458
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Gender | Female
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Dates
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Enumeration Date | 09/05/2026
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Last Update Date | 09/05/2026
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Provider Practice Location Address
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Address Line | 17151 MAIN ST STE C
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City | HESPERIA
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State | CA
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Zip | 92345-6191
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Country | US
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Telephone | 760-695-6006
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Fax | 760-998-2038
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Provider Business Mailing Address
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Address Line | 13432 FAWNCREEK ST
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City | VICTORVILLE
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State | CA
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Zip | 92395-8663
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Country | US
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Telephone | 760-662-8111
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW128458
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License Number State | CA
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