Provider Demographics
NPI:1790209849
Name:CAMPBELL, BRIANNA TARPEY (PPS/ LMFT 113607)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:TARPEY
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PPS/ LMFT 113607
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5681
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-1681
Mailing Address - Country:US
Mailing Address - Phone:925-876-9547
Mailing Address - Fax:
Practice Address - Street 1:555 YGNACIO VALLEY RD UNIT 225
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-3329
Practice Address - Country:US
Practice Address - Phone:925-876-9547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA113607106H00000X
CA170132014101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool