Provider Demographics
NPI:1114416237
Name:BRUNEAU-HERMAN, PRISCILLA SASHA (DCLINPSY)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:SASHA
Last Name:BRUNEAU-HERMAN
Suffix:
Gender:F
Credentials:DCLINPSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 TEHAMA ST STE C
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1681
Mailing Address - Country:US
Mailing Address - Phone:530-710-1070
Mailing Address - Fax:
Practice Address - Street 1:1640 TEHAMA ST STE C
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1681
Practice Address - Country:US
Practice Address - Phone:530-710-1070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist