Provider Demographics
NPI:1477940708
Name:RICHARD BRIGHTMAN, PH.D., A PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:RICHARD BRIGHTMAN, PH.D., A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:BRIGHTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-208-1937
Mailing Address - Street 1:10921 WILSHIRE BOULEVARD
Mailing Address - Street 2:405
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4001
Mailing Address - Country:US
Mailing Address - Phone:310-208-1937
Mailing Address - Fax:
Practice Address - Street 1:10921 WILSHIRE BOULEVARD
Practice Address - Street 2:405
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-4001
Practice Address - Country:US
Practice Address - Phone:310-208-1937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8159103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty