Provider Demographics
NPI:1144410200
Name:BROWN, JAIME HUMBERTO JR (PSY D)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:HUMBERTO
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:265 S RANDOLPH AVE STE 165
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5786
Mailing Address - Country:US
Mailing Address - Phone:714-582-2149
Mailing Address - Fax:714-544-1473
Practice Address - Street 1:265 S RANDOLPH AVE STE 165
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5786
Practice Address - Country:US
Practice Address - Phone:626-581-6752
Practice Address - Fax:714-544-1473
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 25423103TB0200X, 103TC1900X, 103TF0000X, 106H00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist