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General NPI Number Information
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NPI Number | 1689143356
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Entity Type | Individual
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Provider Name | MICHAEL BRENDZAL PSY.D
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Gender | Male
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Dates
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Enumeration Date | 11/24/2018
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Last Update Date | 11/24/2018
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Provider Practice Location Address
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Address Line | 501 W GLENOAKS BLVD # 307
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City | GLENDALE
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State | CA
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Zip | 91202-2896
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Country | US
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Telephone | 626-818-1747
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Fax |
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Provider Business Mailing Address
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Address Line | 501 W GLENOAKS BLVD # 307
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City | GLENDALE
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State | CA
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Zip | 91202-2896
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY18585
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License Number State | CA
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