Provider Demographics
NPI:1275054041
Name:LIKE, BRANDON DOUGLAS (LMFT)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:DOUGLAS
Last Name:LIKE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6558 BING ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-6713
Mailing Address - Country:US
Mailing Address - Phone:858-401-2356
Mailing Address - Fax:
Practice Address - Street 1:6558 BING ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-6713
Practice Address - Country:US
Practice Address - Phone:858-401-2356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-03
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98646106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist