Healthcare Provider Details

I. General information

NPI: 1639162472
Provider Name (Legal Business Name): STEVEN LEE BRIGHAM PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15021 VENTURA BLVD STE 1182
SHERMAN OAKS CA
91403-2442
US

IV. Provider business mailing address

15233 VENTURA BLVD STE PH-4
SHERMAN OAKS CA
91403-2201
US

V. Phone/Fax

Practice location:
  • Phone: 818-275-1072
  • Fax: 909-367-2922
Mailing address:
  • Phone: 818-981-4071
  • Fax: 818-981-4071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY9709
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: