Provider Demographics
NPI:1255523353
Name:BRAMBILA, VERONICA (L THERAPIST)
Entity type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:
Last Name:BRAMBILA
Suffix:
Gender:F
Credentials:L THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49869 CALHOUN ST STE D
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-9720
Mailing Address - Country:US
Mailing Address - Phone:760-398-9090
Mailing Address - Fax:760-391-5338
Practice Address - Street 1:49869 CALHOUN ST STE D
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-9720
Practice Address - Country:US
Practice Address - Phone:760-398-9090
Practice Address - Fax:760-391-5338
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA4000907101YA0400X
106H00000X
CA105581106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)