Provider Demographics
NPI:1770992273
Name:BRAZELL, SUMMER BROOKE
Entity type:Individual
Prefix:MS
First Name:SUMMER
Middle Name:BROOKE
Last Name:BRAZELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8506
Mailing Address - Country:US
Mailing Address - Phone:714-619-0241
Mailing Address - Fax:714-796-2141
Practice Address - Street 1:1575 E 17TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8506
Practice Address - Country:US
Practice Address - Phone:714-619-0241
Practice Address - Fax:714-796-2141
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health