Healthcare Provider Details
I. General information
NPI: 1114038635
Provider Name (Legal Business Name): SARAH BRINDLE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/31/2006
Last Update Date: 03/04/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8335 W SUNSET BLVD STE 248
LOS ANGELES CA
90069-1556
US
IV. Provider business mailing address
5757 RAVENSPUR DR APT 37
RANCHO PALOS VERDES CA
90275-3555
US
V. Phone/Fax
- Phone: 323-925-1262
- Fax: 213-471-1993
- Phone: 323-251-9094
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 20420 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | PSY 20420 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: