Provider Demographics
NPI:1295038727
Name:BRUMIT, SAMUEL A (MFT)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:A
Last Name:BRUMIT
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E SAN MARCOS BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2988
Mailing Address - Country:US
Mailing Address - Phone:760-975-5282
Mailing Address - Fax:
Practice Address - Street 1:1509 VIA DORADO
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-3259
Practice Address - Country:US
Practice Address - Phone:760-975-5282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-05
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33761106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist