Provider Demographics
NPI:1083725030
Name:WILKINSON, BRENDA L (MFT)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:L
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4909 MURPHY CANYON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4301
Mailing Address - Country:US
Mailing Address - Phone:858-268-9800
Mailing Address - Fax:858-268-9810
Practice Address - Street 1:4909 MURPHY CANYON RD STE 300
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4301
Practice Address - Country:US
Practice Address - Phone:858-268-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40435106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist