Provider Demographics
NPI:1093067217
Name:POND, BRIAN W (PPS)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:W
Last Name:POND
Suffix:
Gender:
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S INGLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-2501
Mailing Address - Country:US
Mailing Address - Phone:310-680-2480
Mailing Address - Fax:
Practice Address - Street 1:331 W OLIVE ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-2213
Practice Address - Country:US
Practice Address - Phone:310-680-2480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor