Provider Demographics
NPI:1174141907
Name:THOMAS E. BROWN, PHD, PSYCHOLOGY, P.C.
Entity type:Organization
Organization Name:THOMAS E. BROWN, PHD, PSYCHOLOGY, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-C
Authorized Official - Phone:310-590-7181
Mailing Address - Street 1:500 S SEPULVEDA BLVD STE 218
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6976
Mailing Address - Country:US
Mailing Address - Phone:310-590-7181
Mailing Address - Fax:310-590-7183
Practice Address - Street 1:500 S SEPULVEDA BLVD STE 218
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6976
Practice Address - Country:US
Practice Address - Phone:310-590-7181
Practice Address - Fax:310-590-7183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty