| Joni C Branham Licensed Clinical Social Worker Inc | |
|
645 E Elder St Ste B Fallbrook CA 92028-3084 | |
| (760) 715-6984 | |
| (760) 451-0369 |
| Full Name | Joni C Branham Licensed Clinical Social Worker Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 645 E Elder St Ste B, Fallbrook, California |
| Authorized Official Name and Position | Joni Branham (PSYCHOTHERAPIST) |
| Authorized Official Contact | 7607156984 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joni C Branham Licensed Clinical Social Worker Inc 645 E Elder St Ste B Fallbrook CA 92028-3084 Ph: (760) 715-6984 | Joni C Branham Licensed Clinical Social Worker Inc 645 E Elder St Ste B Fallbrook CA 92028-3084 Ph: (760) 715-6984 |
| NPI Number | 1982187787 |
|---|---|
| Provider Enumeration Date | 09/08/2018 |
| Last Update Date | 09/08/2018 |
| Medicare PECOS PAC ID | 2163760703 |
|---|---|
| Medicare Enrollment ID | O20190206002949 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982187787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Joni Clausing Branham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801022744 PECOS PAC ID: 2860616042 Enrollment ID: I20140609001331 |
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