Provider Demographics
NPI:1760121495
Name:VELASQUEZ, BRIANNA CRISTINA (MA, PPS)
Entity Type:Individual
Prefix:MISS
First Name:BRIANNA
Middle Name:CRISTINA
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:MA, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SIMONI RANCH RD
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-2787
Mailing Address - Country:US
Mailing Address - Phone:925-625-7070
Mailing Address - Fax:
Practice Address - Street 1:100 SIMONI RANCH RD
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-2787
Practice Address - Country:US
Practice Address - Phone:925-625-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty