Basic Information
| Provider Information | |||||||||
| NPI: | 1225322860 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RANSOM | ||||||||
| FirstName: | BRANDI | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | M.A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 923 90TH AVE | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946031251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103253494 | ||||||||
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| Practice Location | |||||||||
| Address1: | 438 N WHITE RD | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951271439 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082546828 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2011 | ||||||||
| LastUpdateDate: | 04/21/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 390200000X | CA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 324500000X | N | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.