Provider Demographics
NPI:1649051871
Name:BEECHUM, BRANDIE
Entity type:Individual
Prefix:
First Name:BRANDIE
Middle Name:
Last Name:BEECHUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12150 PIGEON PASS RD APT I274
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-6977
Mailing Address - Country:US
Mailing Address - Phone:951-482-0345
Mailing Address - Fax:
Practice Address - Street 1:12150 PIGEON PASS RD APT I274
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-6977
Practice Address - Country:US
Practice Address - Phone:951-482-0345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator