Provider Demographics
NPI:1124544960
Name:BRAND, JENNIFER CARYN (MPH, MS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CARYN
Last Name:BRAND
Suffix:
Gender:F
Credentials:MPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4573 INGLEWOOD BLVD APT 3
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-5889
Mailing Address - Country:US
Mailing Address - Phone:818-571-8485
Mailing Address - Fax:
Practice Address - Street 1:4573 INGLEWOOD BLVD APT 3
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-5889
Practice Address - Country:US
Practice Address - Phone:818-571-8485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty