Provider Demographics
NPI:1568226751
Name:BRIGHTMAN, TESS LEE (NP)
Entity Type:Individual
Prefix:
First Name:TESS
Middle Name:LEE
Last Name:BRIGHTMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 RIVERSIDE DR UNIT 125
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-6017
Mailing Address - Country:US
Mailing Address - Phone:508-542-8169
Mailing Address - Fax:
Practice Address - Street 1:1891 EFFIE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-1711
Practice Address - Country:US
Practice Address - Phone:323-644-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028956363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health