Brennecke, Bernadette Leilani
Brennecke, Bernadette Leilani is an sole proprietor health care provider with primary practice located at 4574 Live Oak Canyon Rd , La Verne CA 91750-2312. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Brennecke, Bernadette Leilani can be contacted via phone (909) 263-0851.Contact Information
Primary practice address
4574 Live Oak Canyon Rd
La Verne CA 91750-2312
Phone: (909) 263-0851
Fax: (626) 338-9022
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LG 10677 | California |
Profile Details
| NPI number | 1275756017 |
|---|---|
| LBN Legal business name | Brennecke, Bernadette Leilani |
| Credentials | LSCW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 10th, 2007 |
| Last updated | Feb 27th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275756017 | NPPES |
| California | Other | M0990601 | DRIVERS LICENSE NUMBER |
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