Provider Demographics
NPI:1578305165
Name:BRAND, KASAMA (NP)
Entity type:Individual
Prefix:
First Name:KASAMA
Middle Name:
Last Name:BRAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 DESCANSO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-2514
Mailing Address - Country:US
Mailing Address - Phone:760-280-2230
Mailing Address - Fax:
Practice Address - Street 1:1706 DESCANSO AVE
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2514
Practice Address - Country:US
Practice Address - Phone:760-280-2230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030595363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology