MEDICARE: BRANDY ANDERSON

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
1	374J00000X	Doula

General Provider Information

NPI Number	:	1689420523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDY ANDERSON

Provider Business Mailing Address
First Line	:	1884 MOUNT GOETHE WAY
Second Line	:
City	:	ANTIOCH
State	:	CA
Zip	:	94531-9078
Country	:	US
Telephone Number	:	310-873-7355
Fax Number	:

Provider Business Practice Location Address
First Line	:	5838 OVERHILL DR STE 3
Second Line	:
City	:	WINDSOR HILLS
State	:	CA
Zip	:	90043-2738
Country	:	US
Telephone Number	:	310-873-7355
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2024
Last Update Date	:	04/30/2024

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Directions to “ BRANDY ANDERSON ” Practice Location

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