Provider Demographics
NPI:1134259385
Name:COMPLIMENT, BRAD KENNETH (PHD PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:BRAD
Middle Name:KENNETH
Last Name:COMPLIMENT
Suffix:
Gender:M
Credentials:PHD PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE COUNSELING CENTER AT UCR
Mailing Address - Street 2:VEITCH CENTER, NORTH WING
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92521-0001
Mailing Address - Country:US
Mailing Address - Phone:951-827-5531
Mailing Address - Fax:
Practice Address - Street 1:THE COUNSELING CENTER AT UCR
Practice Address - Street 2:VEITCH CENTER, NORTH WING
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92521-0001
Practice Address - Country:US
Practice Address - Phone:951-827-5531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16542103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling