Provider Demographics
NPI:1346316197
Name:BROWN, THOMAS E (PH D)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:BROWN
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S SEPULVEDA BLVD STE 218
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6976
Mailing Address - Country:US
Mailing Address - Phone:310-590-7181
Mailing Address - Fax:310-590-7183
Practice Address - Street 1:500 S SEPULVEDA BLVD STE 218
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6976
Practice Address - Country:US
Practice Address - Phone:310-590-7181
Practice Address - Fax:310-590-7183
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29849103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical