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General NPI Number Information
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NPI Number | 1376414144
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Entity Type | Individual
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Provider Name | BRANDYN EUGENE BETTENCOURT MA, PPSC
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Gender | Male
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 3411 ROCKY MOUNTAIN DR
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City | SAN JOSE
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State | CA
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Zip | 95127-4853
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Country | US
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Telephone | 408-258-7288
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Fax | 408-272-9646
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Provider Business Mailing Address
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Address Line | 15425 OAK GLEN AVE
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City | MORGAN HILL
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State | CA
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Zip | 95037-8802
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Country | US
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Telephone | 408-258-7288
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Fax | 408-272-9646
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 240120116
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License Number State | CA
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