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NPI 1811367410

NPI 1811367410 : BRENDT PARRISH PH.D. : OCEANSIDE, CA

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General NPI Number Information
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    NPI Number           |    1811367410
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    Entity Type          |    Individual 
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    Provider Name        |    BRENDT PARRISH PH.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/25/2015
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    Last Update Date     |    11/19/2015
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Provider Practice Location Address
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    Address Line         |    1300 RANCHO DEL ORO RD 
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    City                 |    OCEANSIDE
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    State                |    CA
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    Zip                  |    92056-1729
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    Country              |    US
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    Telephone            |    760-643-2000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3115 S MILL AVE # 180 
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    City                 |    TEMPE
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    State                |    AZ
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    Zip                  |    85282-3653
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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       |    2356
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    License Number State |    KS
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