Provider Demographics
NPI:1245865492
Name:FERRON, BRIANA MAE
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:MAE
Last Name:FERRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:MAE
Other - Last Name:HABEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:959 E COLORADO BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2337
Mailing Address - Country:US
Mailing Address - Phone:562-708-2236
Mailing Address - Fax:
Practice Address - Street 1:959 E COLORADO BLVD STE 220
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2337
Practice Address - Country:US
Practice Address - Phone:562-708-2236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-09
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT117861106H00000X
CA130324106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist