| Ashley Nichole Branham, LCSW | |
|
16940 Highway 14, Mojave, CA 93501-1238 | |
| (661) 824-5020 | |
| (661) 824-5026 |
| Full Name | Ashley Nichole Branham |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 16940 Highway 14, Mojave, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194863464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 82398 (California) | Primary |
| Entity Name | Northeast Valley Health Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629079009 PECOS PAC ID: 3173517323 Enrollment ID: O20040412001067 |
| Mailing Address | Practice Location Address |
|---|---|
| Ashley Nichole Branham, LCSW Po Box 4625, Panorama City, CA 91412-4625 Ph: (804) 397-7733 | Ashley Nichole Branham, LCSW 16940 Highway 14, Mojave, CA 93501-1238 Ph: (661) 824-5020 |
Juan Manuel Amezcua, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 16940 Highway 14, Mojave, CA 93501 Phone: 661-824-5020 | |
Moritha S. Alli, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 16940 Highway 14 Ste F, Mojave, CA 93501 Phone: 661-824-5020 | |
Elizabeth Gomez, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 16940 Highway 14 Ste F, Mojave, CA 93501 Phone: 661-824-5020 |