Provider Demographics
NPI:1720748171
Name:BRADEN, JANET (ASW)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:BRADEN
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:QUINTERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:943 N GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-2046
Mailing Address - Country:US
Mailing Address - Phone:626-960-2995
Mailing Address - Fax:
Practice Address - Street 1:943 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-2046
Practice Address - Country:US
Practice Address - Phone:626-960-2995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1030081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical