Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | 11854 | CA |
NPI | 1063579365 |
---|---|
Provider Name | Mrs. Ronda Lynn Brandt |
First Address | Redwood City, CA 94063-5528 |
Second Address | Redwood City, CA 94063-2037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 30/12/2021 |