Provider Demographics
NPI:1891361085
Name:BRONER, IRIT ESTER
Entity type:Individual
Prefix:
First Name:IRIT
Middle Name:ESTER
Last Name:BRONER
Suffix:
Gender:F
Credentials:
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 2214
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-0214
Mailing Address - Country:US
Mailing Address - Phone:209-803-8110
Mailing Address - Fax:
Practice Address - Street 1:220 CALIFORNIA AVE STE 105
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1627
Practice Address - Country:US
Practice Address - Phone:650-319-7225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT117719106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist