Provider Demographics
NPI:1285864918
Name:BRENER, MADELINE ESTHER (PSYD)
Entity type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:ESTHER
Last Name:BRENER
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MADELINE
Other - Middle Name:ESTHER BRENER
Other - Last Name:WESH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2505 OLD QUARRY RD APT 1516
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-2766
Mailing Address - Country:US
Mailing Address - Phone:619-267-9257
Mailing Address - Fax:
Practice Address - Street 1:5005 TEXAS ST
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3721
Practice Address - Country:US
Practice Address - Phone:619-692-0727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
CAPSY31736103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist