Organization Name: | BRAD STENBERG, D.MFT. |
NPI Number: | 1578774733 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRADLEY ALAN STENBERG (DIRECTOR) |
Mailing Address: | 156 W Sierra Madre Blvd Suite 2 Sierra Madre |
State: | CA US |
Postal Code: | 910242435 |
Phone Number: | 6267162489 |
Fax Number: | 6263550512 |
NPI Enumeration Date: | 05/26/2007 |
NPI Last Update Date: | 03/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | MFC 33201 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |