Provider Demographics
NPI:1356017974
Name:MENCHEL, BRENDA ELLEN
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:ELLEN
Last Name:MENCHEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18663 VENTURA BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4161
Mailing Address - Country:US
Mailing Address - Phone:818-963-9319
Mailing Address - Fax:818-657-7440
Practice Address - Street 1:18663 VENTURA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4161
Practice Address - Country:US
Practice Address - Phone:818-963-9319
Practice Address - Fax:818-657-7440
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty