Provider Demographics
NPI:1417531492
Name:BRANDY, REBECCA EINSTEIN
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:EINSTEIN
Last Name:BRANDY
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 1:2115 PANORAMA TER
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-3540
Mailing Address - Country:US
Mailing Address - Phone:310-560-4996
Mailing Address - Fax:
Practice Address - Street 1:2115 PANORAMA TER
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-3540
Practice Address - Country:US
Practice Address - Phone:310-560-4996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)