Provider Demographics
NPI:1407255235
Name:BRAN, AMPARO
Entity Type:Individual
Prefix:MRS
First Name:AMPARO
Middle Name:
Last Name:BRAN
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 1:921 HILLSIDE ST
Mailing Address - Street 2:#32
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-2866
Mailing Address - Country:US
Mailing Address - Phone:562-547-6307
Mailing Address - Fax:
Practice Address - Street 1:921 HILLSIDE ST
Practice Address - Street 2:32
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-2866
Practice Address - Country:US
Practice Address - Phone:562-547-6307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health