Individual
MS. BERNADETTE LEILANI BRENNECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCW
Contact information
Practice address
4574 LIVE OAK CANYON RD, LA VERNE, CA 91750-2312
(909) 263-0851
(626) 338-9022
Mailing address
640 S SUNSET AVE STE 102, WEST COVINA, CA 91790-2808
(909) 263-0851
(626) 338-9022
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LG 10677
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M0990601
DRIVERS LICENSE NUMBER
CA
Enumeration date
04/10/2007
Last updated
02/27/2024
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