Provider Demographics
NPI:1518738921
Name:BREMHORST, KERRY (LMFT)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:BREMHORST
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 LA CASA DR
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-4149
Mailing Address - Country:US
Mailing Address - Phone:925-818-4981
Mailing Address - Fax:
Practice Address - Street 1:191 SAND CREEK RD STE 202M
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2215
Practice Address - Country:US
Practice Address - Phone:925-818-4981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135774106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist