Provider Demographics
NPI:1841576733
Name:BRANDON, JULIENNE MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JULIENNE
Middle Name:MARIE
Last Name:BRANDON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7316 PALM TREE CIR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-6940
Mailing Address - Country:US
Mailing Address - Phone:661-399-5080
Mailing Address - Fax:661-706-7727
Practice Address - Street 1:2441 G ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2809
Practice Address - Country:US
Practice Address - Phone:661-631-8793
Practice Address - Fax:661-631-9257
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6469225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist