Provider Demographics
NPI:1003951054
Name:LOYCE, BRYAN JAMES (MA, MA)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:JAMES
Last Name:LOYCE
Suffix:
Gender:M
Credentials:MA, MA
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 23265
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-3265
Mailing Address - Country:US
Mailing Address - Phone:714-393-4793
Mailing Address - Fax:619-225-9672
Practice Address - Street 1:2351 CARDINAL LN., ANNEX B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:619-225-9621
Practice Address - Fax:619-225-9672
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF55119106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist