Provider Demographics
NPI:1912514522
Name:LEMUS, BRIANDA CECILIA (ASW)
Entity Type:Individual
Prefix:MISS
First Name:BRIANDA
Middle Name:CECILIA
Last Name:LEMUS
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 MCCALL AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662-2560
Mailing Address - Country:US
Mailing Address - Phone:559-436-0482
Mailing Address - Fax:
Practice Address - Street 1:3400 MCCALL AVE STE 104
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-2560
Practice Address - Country:US
Practice Address - Phone:559-436-0482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA96490101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist