Provider Demographics
NPI:1891193025
Name:PILEGARD, BRENT (MFTI, CHT)
Entity type:Individual
Prefix:MR
First Name:BRENT
Middle Name:
Last Name:PILEGARD
Suffix:
Gender:M
Credentials:MFTI, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 W OJAI AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-3732
Mailing Address - Country:US
Mailing Address - Phone:804-407-8235
Mailing Address - Fax:
Practice Address - Street 1:603 W OJAI AVE
Practice Address - Street 2:SUITE F
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-3732
Practice Address - Country:US
Practice Address - Phone:804-407-8235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78019106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist