Provider Demographics
NPI:1487001434
Name:CHUMAN, BRANDON R (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:R
Last Name:CHUMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 PASEO VERDE PKWY STE 190
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2703
Mailing Address - Country:US
Mailing Address - Phone:702-589-4871
Mailing Address - Fax:
Practice Address - Street 1:2200 PASEO VERDE PKWY STE 190
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2703
Practice Address - Country:US
Practice Address - Phone:702-589-4871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28338103G00000X
NC5509103T00000X
NVPY1041103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist