| Bernadette L. Brennecke, Lcsw, Inc. | |
|
4574 Live Oak Canyon Road La Verne CA 91750 | |
| (909) 263-0851 | |
| (626) 338-9022 |
| Full Name | Bernadette L. Brennecke, Lcsw, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4574 Live Oak Canyon Road, La Verne, California |
| Authorized Official Name and Position | Greg Petropoulos (OWNER/THERAPIST) |
| Authorized Official Contact | 9092630934 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bernadette L. Brennecke, Lcsw, Inc. 640 S. Sunset Ave Suite 102 West Covina CA 91790 Ph: (909) 263-0851 | Bernadette L. Brennecke, Lcsw, Inc. 4574 Live Oak Canyon Road La Verne CA 91750 Ph: (909) 263-0851 |
| NPI Number | 1902121940 |
|---|---|
| Provider Enumeration Date | 04/01/2010 |
| Last Update Date | 03/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902121940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MFC 37681 (California) | Primary |
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