Provider Demographics
NPI:1134490725
Name:BRODY, MARTA SCHNEIDER (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARTA
Middle Name:SCHNEIDER
Last Name:BRODY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34016 WEBFOOT LOOP
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-2975
Mailing Address - Country:US
Mailing Address - Phone:510-713-2995
Mailing Address - Fax:
Practice Address - Street 1:34016 WEBFOOT LOOP
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-2975
Practice Address - Country:US
Practice Address - Phone:510-676-9665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-13
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16583103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist