Provider Demographics
NPI:1407214091
Name:BROOKS, BRANDY AMBER (PA-C, EDD)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:AMBER
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PA-C, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0415
Mailing Address - Country:US
Mailing Address - Phone:360-709-9500
Mailing Address - Fax:661-865-5009
Practice Address - Street 1:4850 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0415
Practice Address - Country:US
Practice Address - Phone:661-865-5009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2020-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60620738363A00000X
CA56320363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant