Provider Demographics
NPI:1306007646
Name:PHIPPS, BRION (LCSW)
Entity Type:Individual
Prefix:
First Name:BRION
Middle Name:
Last Name:PHIPPS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 EMBARCADERO STE 305
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-5300
Mailing Address - Country:US
Mailing Address - Phone:508-954-0714
Mailing Address - Fax:
Practice Address - Street 1:2000 EMBARCADERO STE 305
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-5300
Practice Address - Country:US
Practice Address - Phone:508-954-0714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW237561041C0700X
CALCS285931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical