Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 33086 | CA |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY33086 | CA |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1144717828 |
---|---|
Provider Name | Dr. Brenda Osorio |
First Address | Santa Monica, CA 90404-2033 |
Second Address | Santa Monica, CA 90404-2033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2018 |
Last Update Date | 23/12/2021 |