Active NPI
Brandon Edward Williams
- Peer Specialist
- Los Angeles, CA
National Provider Identifier
1972334407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 3881 S Western Ave
Los Angeles, CA 90062-1105 - Phone
- (323) 290-4340
- NPI assigned
- Aug 7, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary | ||
| Community Health Worker | 172V00000X |
Addresses
Primary practice location
3881 S Western Ave
Los Angeles, CA 90062-1105
Mailing address
4706 2ND Ave
Los Angeles, CA 90043-1454
Phone (310) 880-3486
Other practice location 1
679 S New Hampshire Ave Fl 4
Los Angeles, CA 90005-1355
Phone (213) 639-2500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736812800000",
"number": "1972334407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4706 2ND AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900431454",
"telephone_number": "310-880-3486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3881 S WESTERN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900621105",
"telephone_number": "323-290-4340"
}
],
"practiceLocations": [
{
"address_1": "679 S New Hampshire Ave Fl 4",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900051355",
"country_code": "US",
"telephone_number": "213-639-2500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "BRANDON",
"middle_name": "EDWARD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-08-07",
"last_updated": "2025-01-14",
"certification_date": "2025-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.