Individual
BERNADETTE BRASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
6815 NOBLE AVE, VAN NUYS, CA 91405-3796
(818) 901-6600
(818) 997-7826
Mailing address
1610 DRY CREEK DR, STE 200, LONGMONT, CO 80503-6405
(818) 901-6600
(818) 997-7826
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PTL.0016293
CO
2251X0800X
Orthopedic Physical Therapist
Primary
PT30174
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT30174
STATE LICENSE
CA
Enumeration date
03/08/2007
Last updated
11/07/2019
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