Provider Demographics
NPI:1063399715
Name:KOUNTZ, BRENDA LOUISE (PSYCHIATRIC AIDE II)
Entity type:Individual
Prefix:MISS
First Name:BRENDA
Middle Name:LOUISE
Last Name:KOUNTZ
Suffix:
Gender:F
Credentials:PSYCHIATRIC AIDE II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 863
Mailing Address - Street 2:
Mailing Address - City:LOS MOLINOS
Mailing Address - State:CA
Mailing Address - Zip Code:96055-0863
Mailing Address - Country:US
Mailing Address - Phone:530-762-9323
Mailing Address - Fax:
Practice Address - Street 1:1860 WALNUT ST STE A
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-3611
Practice Address - Country:US
Practice Address - Phone:530-762-9323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker