Provider Demographics
NPI:1679115943
Name:BRUM, ALEC CHRISTIAN
Entity Type:Individual
Prefix:
First Name:ALEC
Middle Name:CHRISTIAN
Last Name:BRUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12437 LEWIS ST STE 100
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-4651
Mailing Address - Country:US
Mailing Address - Phone:805-691-9483
Mailing Address - Fax:
Practice Address - Street 1:1927 CASTILLO ST APT 1
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2848
Practice Address - Country:US
Practice Address - Phone:805-403-6269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst