Provider Demographics
NPI:1386512309
Name:SAUCEDO, BRENDA FLOR (LMT)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:FLOR
Last Name:SAUCEDO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38629 4TH ST E
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-3705
Mailing Address - Country:US
Mailing Address - Phone:661-544-5486
Mailing Address - Fax:
Practice Address - Street 1:41770 12TH ST W STE C
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1424
Practice Address - Country:US
Practice Address - Phone:661-544-5486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41060225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty