Provider Demographics
NPI:1073507976
Name:LIEBSCHER, BRANDY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRANDY
Middle Name:
Last Name:LIEBSCHER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 HILLTOP DR
Mailing Address - Street 2:SUITE 15
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-0511
Mailing Address - Country:US
Mailing Address - Phone:530-365-4369
Mailing Address - Fax:530-365-4617
Practice Address - Street 1:1714 WEST ST
Practice Address - Street 2:2ND FL
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1725
Practice Address - Country:US
Practice Address - Phone:530-365-4369
Practice Address - Fax:530-365-4617
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19250103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPL192500Medicare ID - Type Unspecified