Provider Demographics
NPI:1073865010
Name:JOANNE BRANKIN INC
Entity Type:Organization
Organization Name:JOANNE BRANKIN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:310-980-6675
Mailing Address - Street 1:6724 HILLPARK DR
Mailing Address - Street 2:#304
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-2169
Mailing Address - Country:US
Mailing Address - Phone:310-980-6675
Mailing Address - Fax:
Practice Address - Street 1:6724 HILLPARK DR
Practice Address - Street 2:#304
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-2169
Practice Address - Country:US
Practice Address - Phone:310-980-6675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-14
Last Update Date:2012-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 6825225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty