Provider Demographics
NPI:1083192868
Name:BRANDA, REBECCA MICHELLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MICHELLE
Last Name:BRANDA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:MICHELLE
Other - Last Name:STEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5450 TRABUCO RD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-5704
Mailing Address - Country:US
Mailing Address - Phone:213-347-4718
Mailing Address - Fax:
Practice Address - Street 1:16530 VENTURA BLVD STE 306
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4595
Practice Address - Country:US
Practice Address - Phone:213-347-4718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist