Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 48104 | CA |
N | 101YM0800X | Mental Health Counselor | 48104 | CA |
N | 101YP1600X | Pastoral Counselor | 48104 | CA |
N | 101YP2500X | Professional Counselor | 48104 | CA |
N | 103G00000X | Clinical Psychologist | 48104 | CA |
N | 103TC0700X | Clinical Psychologist | 48104 | CA |
NPI | 1134315401 |
---|---|
Provider Name | Dr. Brenda-Joyce G Markert-Green |
First Address | San Bernardino, CA 92423-3217 |
Second Address | Riverside, CA 92504-1709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2007 |
Last Update Date | 06/04/2012 |