Provider Demographics
NPI:1851536247
Name:BRADBERRY, SERENA PERRY (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SERENA
Middle Name:PERRY
Last Name:BRADBERRY
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 1:3611 S HARBOR BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-7915
Mailing Address - Country:US
Mailing Address - Phone:909-609-6024
Mailing Address - Fax:
Practice Address - Street 1:23311 DRACAEA AVE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-3201
Practice Address - Country:US
Practice Address - Phone:951-571-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-13
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA97772106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist