Healthcare Provider Details

I. General information

NPI: 1578641098
Provider Name (Legal Business Name): CHAD DAVID BRINDERSON PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 PACIFIC COAST HWY STE 103
HERMOSA BEACH CA
90254-2734
US

IV. Provider business mailing address

2401 PCH HWY STE 103
HERMOSA BEACH CA
90254-2734
US

V. Phone/Fax

Practice location:
  • Phone: 310-291-0851
  • Fax: 310-782-3461
Mailing address:
  • Phone: 310-291-0851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number15106
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: