Provider Demographics
NPI:1265003677
Name:BROWN,, KEIANN
Entity Type:Individual
Prefix:
First Name:KEIANN
Middle Name:
Last Name:BROWN,
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5080 CALIFORNIA AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0732
Mailing Address - Country:US
Mailing Address - Phone:661-258-3240
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:5080 CALIFORNIA AVE STE 250
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0732
Practice Address - Country:US
Practice Address - Phone:661-258-3240
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician