Provider Demographics
NPI:1578305165
Name:BRAND, KASAMA (NP)
Entity type:Individual
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First Name:KASAMA
Middle Name:
Last Name:BRAND
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Gender:F
Credentials:NP
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Mailing Address - Street 1:10565 CIVIC CENTER DR STE 250
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3854
Mailing Address - Country:US
Mailing Address - Phone:626-696-1400
Mailing Address - Fax:626-696-1451
Practice Address - Street 1:1955 CITRACADO PKWY STE 203
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-4112
Practice Address - Country:US
Practice Address - Phone:760-738-5533
Practice Address - Fax:760-738-3835
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-09-03
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Provider Licenses
StateLicense IDTaxonomies
CA95030595363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology