Provider Demographics
NPI:1205364635
Name:HEIMBERG, BRANDON FREIBERG (PSYD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:FREIBERG
Last Name:HEIMBERG
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:21300 DUMETZ RD APT G
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-4409
Mailing Address - Country:US
Mailing Address - Phone:646-687-1004
Mailing Address - Fax:855-943-3312
Practice Address - Street 1:5000 PARKWAY CALABASAS STE 218
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3909
Practice Address - Country:US
Practice Address - Phone:424-234-1155
Practice Address - Fax:855-943-3312
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0262737103TC0700X, 103G00000X
CAPSY33820103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical