Provider Demographics
NPI:1689972051
Name:LITTELL, BRENT (MFTI)
Entity Type:Individual
Prefix:MR
First Name:BRENT
Middle Name:
Last Name:LITTELL
Suffix:
Gender:M
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 E ORANGEWOOD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-6138
Mailing Address - Country:US
Mailing Address - Phone:714-543-4333
Mailing Address - Fax:714-543-4398
Practice Address - Street 1:2390 E ORANGEWOOD AVE STE 300
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-6138
Practice Address - Country:US
Practice Address - Phone:714-543-4333
Practice Address - Fax:714-543-4398
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81928106H00000X
CA58802106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist