Provider Demographics
NPI:1407456288
Name:BRANT, MARIA BELINDA
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:BELINDA
Last Name:BRANT
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MARIA
Other - Middle Name:BELINDA
Other - Last Name:MARCOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8900 BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-2438
Mailing Address - Country:US
Mailing Address - Phone:310-423-3281
Mailing Address - Fax:310-248-6550
Practice Address - Street 1:8900 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-2438
Practice Address - Country:US
Practice Address - Phone:310-423-3281
Practice Address - Fax:310-248-6550
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014305363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health