Provider Demographics
NPI:1063968550
Name:CASWELL, BRANDI
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:
Last Name:CASWELL
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 1:2235 MERCURY WAY STE 107
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95407-5472
Mailing Address - Country:US
Mailing Address - Phone:707-787-6400
Mailing Address - Fax:
Practice Address - Street 1:2235 MERCURY WAY STE 107
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407-5472
Practice Address - Country:US
Practice Address - Phone:707-571-5581
Practice Address - Fax:707-571-5531
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist