Provider Demographics
NPI:1609565092
Name:CARLTON, BRANDON DALE
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:DALE
Last Name:CARLTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BRANDON
Other - Middle Name:D
Other - Last Name:CARLTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2145 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-1617
Mailing Address - Country:US
Mailing Address - Phone:805-901-4710
Mailing Address - Fax:
Practice Address - Street 1:2145 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-1617
Practice Address - Country:US
Practice Address - Phone:805-901-4710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst