Joni C Branham Licensed Clinical Social Worker Inc
Organization Active NPI Community/Behavioral Health Agency · Fallbrook, CA
NPI 1982187787 · NPPES record last updated Sep 8, 2018
Key facts
- NPI
- 1982187787
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- JONI C BRANHAM LICENSED CLINICAL SOCIAL WORKER INC
- Practice address
- 645 E Elder St Ste B
Fallbrook, CA 92028-3084 - Phone
- (760) 715-6984
- Fax
- (760) 451-0369
- NPI assigned
- Sep 8, 2018
- Organization subpart
- No
Authorized official
- Name
- Joni Branham, LCSW
- Title
- Psychotherapist
- Phone
- (760) 715-6984
Practitioners 1
-
Joni Clausing Branham, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190206002949 | CA | Part B Supplier - Clinic/Group Practice | 2163760703 |
Receives reassigned benefits from 1 practitioner Practice locations: Fallbrook, CA |
National Provider Directory
Locations
645 E Elder St
Ste B
Fallbrook, CA 92028
Phone (760) 715-6984
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
645 E Elder St Ste B
Fallbrook, CA 92028-3084
Mailing address
645 E Elder St Ste B
Fallbrook, CA 92028-3084
Phone (760) 715-6984
Other providers in Fallbrook, CA
- Teresa Jimenez
- Angela Maricela Johnson
- Dylan Keahi Johnson
- Patricia Marie Johnson
- Michael E Jones
- Joshean Nursing Corporation
- Sara Ann Joubert
- Leonora Jui
- JW Durable Mecical Equipment
- Kaleena Prate Licensed Marriage & Family Therapist, Inc.
All providers in Fallbrook, CA · Community/Behavioral Health Agency in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.