Provider Demographics
NPI:1275872814
Name:BRANDT, ELIZABETH ALDEN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ALDEN
Last Name:BRANDT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ALDEN
Other - Last Name:BRANDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1006
Mailing Address - Street 2:21701 STEVEN'S CREEK BLVD.
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95015-1006
Mailing Address - Country:US
Mailing Address - Phone:408-642-0236
Mailing Address - Fax:
Practice Address - Street 1:10100 FINCH AVE
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3411
Practice Address - Country:US
Practice Address - Phone:408-366-7365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
CAMFTI 75375106H00000X
CA102427106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health