Provider Demographics
NPI:1427743400
Name:FELDMAN, BRIAN ELIOTT (PHD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ELIOTT
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61104
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-6104
Mailing Address - Country:US
Mailing Address - Phone:650-814-9119
Mailing Address - Fax:
Practice Address - Street 1:1510 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1220
Practice Address - Country:US
Practice Address - Phone:650-814-9119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY4904103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical