| Doctor Name: | MR. KENNETH JOHN BRENIMAN |
| NPI Number: | 1457651689 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW, RYT |
| License Number: | 25705 YOGA ALLIANCE |
| Business Practice Address: | 1511 Jefferson St Townhouse 9 Oakland, CA - 946121402 |
| Business Phone Number: | 5103882884 |
| Business Fax Number: | |
| Mailing Address: | 1511 Jefferson St, Townhouse 9 OAKLAND |
| State: | CA |
| Postal Code: | 946121402 |
| Phone Number: | 5103882884 |
| Fax Number: | |
| NPI Enumeration Date: | 10/21/2010 |
| NPI Last Update Date: | 10/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225500000X |
| License Number: | 25705 YOGA ALLIANCE |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | General classification identifying individuals who are trained on a specific piece of equipment or technical procedure. |