Provider Demographics
NPI:1346699378
Name:CHOUR, BRENDA (COMMUNITY WORKER)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:CHOUR
Suffix:
Gender:F
Credentials:COMMUNITY WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 N GRAND AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-1016
Mailing Address - Country:US
Mailing Address - Phone:213-505-0210
Mailing Address - Fax:626-331-0121
Practice Address - Street 1:1359 N GRAND AVE STE 201
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-1016
Practice Address - Country:US
Practice Address - Phone:213-505-0210
Practice Address - Fax:626-331-0121
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker