Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DEODRA BROADNAX
Active Sole ProprietorDEODRA BROADNAX is a Behavioral Health, Residential healthcare provider located in GARDENA, California. NPI 1548879489 is currently active in the NPPES registry. Verify at CMS.
Behavioral Health, Residential · GARDENA, CA
Registration Details
- NPI Number
- 1548879489
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 27, 2020 (6.0833679156805 yrs)
- Last Updated
- Jul 27, 2020
- Sole Proprietor
- Yes
Practice Information
- Address
-
1451 MARINE AVE APT DGARDENA, CA, 902473331Browse CA providers · Browse ZIP 90247
- Phone
- 3109910023
- Primary Specialty
-
Behavioral Health, Residential
251C00000X
Other Behavioral Health, Residential Providers in GARDENA, CA
| Name | Credential | NPI |
|---|---|---|
| MICHELLE WRIGHT | SIGN LANGUAGE | 1932718871 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.