Provider Demographics
NPI:1659491173
Name:KLIER, BRUCE JOHN (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:JOHN
Last Name:KLIER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 MEADOW LARK DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2711
Mailing Address - Country:US
Mailing Address - Phone:858-694-4695
Mailing Address - Fax:858-694-4492
Practice Address - Street 1:2901 MEADOW LARK DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2711
Practice Address - Country:US
Practice Address - Phone:858-694-4695
Practice Address - Fax:858-694-4492
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6585103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist