Provider Demographics
NPI:1942791595
Name:KRESS, BRENNA RENAE
Entity Type:Individual
Prefix:
First Name:BRENNA
Middle Name:RENAE
Last Name:KRESS
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 1:6121 SALEM RD
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-4786
Mailing Address - Country:US
Mailing Address - Phone:714-270-8841
Mailing Address - Fax:
Practice Address - Street 1:6200 E CANYON RIM RD STE 212
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-4317
Practice Address - Country:US
Practice Address - Phone:714-270-8841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106051106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist