Provider Demographics
NPI:1568080950
Name:DAVIS, BRANDI ANN (LMFT)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44025 MARGARITA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-2728
Mailing Address - Country:US
Mailing Address - Phone:661-347-6679
Mailing Address - Fax:951-331-3843
Practice Address - Street 1:44025 MARGARITA RD STE 101
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-2728
Practice Address - Country:US
Practice Address - Phone:661-347-6679
Practice Address - Fax:951-331-3843
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-11
Last Update Date:2020-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52361106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist