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General NPI Number Information
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NPI Number | 1578774733
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Entity Type | Organization
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Legal Business Name | BRAD STENBERG, D.MFT.
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Dates
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Enumeration Date | 05/26/2007
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 156 W SIERRA MADRE BLVD SUITE 2
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City | SIERRA MADRE
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State | CA
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Zip | 91024-2435
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Country | US
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Telephone | 626-716-2489
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Fax | 626-355-0512
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Provider Business Mailing Address
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Address Line | 170 W SIERRA MADRE BLVD
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City | SIERRA MADRE
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State | CA
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Zip | 91024-2435
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Country | US
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Telephone | 626-716-2489
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Fax | 626-355-0512
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. BRADLEY ALAN STENBERG
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Credential | PSY.D.
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Telephone | 626-716-2489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | MFC 33201
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License Number State | CA
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