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NPI Code Detail

MEDICARE: RENEE BRAZELL

MEDICARE: RENEE BRAZELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1588159198
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEE BRAZELL
Provider Business Mailing Address
First Line : 11027 BURBANK BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91601-2431
Country : US
Telephone Number : 818-985-8323
Fax Number :
Provider Business Practice Location Address
First Line : 2029 KEITH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-3128
Country : US
Telephone Number : 213-721-0010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2018
Last Update Date : 05/15/2025

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Directions to “ RENEE BRAZELL ” Practice Location

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