Individual
BRANDI ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
231 E ALESSANDRO BLVD # A259, RIVERSIDE, CA 92508-5084
(951) 406-7534
Mailing address
231 E ALESSANDRO BLVD # A259, RIVERSIDE, CA 92508-5084
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
10/19/2017
Last updated
10/19/2020
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