Provider Demographics
NPI:1295358364
Name:NIERENBERG, BRENDAN JOSEPH (LMFT)
Entity Type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:JOSEPH
Last Name:NIERENBERG
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:DR
Other - First Name:BRENDAN
Other - Middle Name:JOSEPH
Other - Last Name:NIERENBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:1461 BUSTER ST
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-3217
Mailing Address - Country:US
Mailing Address - Phone:818-620-7148
Mailing Address - Fax:
Practice Address - Street 1:9713 SANTA MONICA BLVD STE 207
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4243
Practice Address - Country:US
Practice Address - Phone:833-624-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-24
Last Update Date:2021-04-14
Deactivation Date:2020-11-26
Deactivation Code:
Reactivation Date:2021-01-20
Provider Licenses
StateLicense IDTaxonomies
CA118762101YM0800X, 106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health