Provider Demographics
NPI:1467119594
Name:BRANDON, MARILYN LADEAN (SOCIAL WORKER II)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:LADEAN
Last Name:BRANDON
Suffix:
Gender:F
Credentials:SOCIAL WORKER II
Other - Prefix:
Other - First Name:MARILYN
Other - Middle Name:LADEAN
Other - Last Name:LOWERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1177 FRANCISCO BLVD E
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-5403
Mailing Address - Country:US
Mailing Address - Phone:415-720-6840
Mailing Address - Fax:
Practice Address - Street 1:1177 FRANCISCO BLVD E
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-5403
Practice Address - Country:US
Practice Address - Phone:415-720-6840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator