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General NPI Number Information
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NPI Number | 1104392950
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Entity Type | Individual
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Provider Name | BRANDON KENNETH MALDE-ZORADI LMFT, LPCC
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Gender | Male
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Dates
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Enumeration Date | 10/19/2018
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 4325 W SUNSET BLVD STE 206
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City | LOS ANGELES
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State | CA
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Zip | 90029-2180
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Country | US
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Telephone | 805-705-7211
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Fax |
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Provider Business Mailing Address
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Address Line | 11049 MCCORMICK ST APT 304
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-6201
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | CA
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