Provider Demographics
NPI:1174396162
Name:STRAYER, BROOKE LEANN
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:LEANN
Last Name:STRAYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5891 MILANA DR
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-8625
Mailing Address - Country:US
Mailing Address - Phone:951-642-8473
Mailing Address - Fax:
Practice Address - Street 1:5891 MILANA DR
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-8625
Practice Address - Country:US
Practice Address - Phone:951-642-8473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst