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General NPI Number Information
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NPI Number | 1972391373
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Entity Type | Individual
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Provider Name | BREANNA CRUZ
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Gender | Female
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Dates
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Enumeration Date | 04/28/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 17270 BEAR VALLEY RD STE 106
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City | VICTORVILLE
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State | CA
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Zip | 92395-7751
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Country | US
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Telephone | 183-690-9375
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Fax |
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Provider Business Mailing Address
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Address Line | 16407 NISQUALLI RD
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City | VICTORVILLE
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State | CA
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Zip | 92395-8904
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Country | US
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Telephone | 909-490-9173
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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 | 9427
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License Number State | CA
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