Individual
DR. BRENDA LILIANA GANDARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
15615 ALTON PKWY STE 230, IRVINE, CA 92618-7306
(949) 528-6300
Mailing address
15615 ALTON PKWY STE 230, IRVINE, CA 92618-7306
(949) 528-6300
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY31390
CA
225400000X
Rehabilitation Practitioner
—
CA
225400000X
Rehabilitation Practitioner
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
11/10/2017
Last updated
10/05/2020
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