Provider Demographics
NPI:1366930752
Name:FRANZ, BRENDA CONNOLLY (PSYD)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:CONNOLLY
Last Name:FRANZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2456 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-2022
Mailing Address - Country:US
Mailing Address - Phone:760-685-6624
Mailing Address - Fax:619-736-1584
Practice Address - Street 1:2456 BROADWAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92102-2022
Practice Address - Country:US
Practice Address - Phone:760-685-6624
Practice Address - Fax:619-736-1584
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA10231146826OtherMEDI-CAL