Provider Demographics
NPI:1215647581
Name:BRANNER, CHERAE MYCHEL
Entity type:Individual
Prefix:
First Name:CHERAE
Middle Name:MYCHEL
Last Name:BRANNER
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 1:3950 THORNBURGH PL
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-1117
Mailing Address - Country:US
Mailing Address - Phone:310-895-3907
Mailing Address - Fax:
Practice Address - Street 1:3950 THORNBURGH PL
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-1117
Practice Address - Country:US
Practice Address - Phone:310-895-3907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician