Provider Demographics
NPI:1891029450
Name:BREWSTER, VERONICA ANNE
Entity Type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:ANNE
Last Name:BREWSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:VERONICA
Other - Middle Name:ANNE
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1012 MAIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RAMONA
Mailing Address - State:CA
Mailing Address - Zip Code:92065-2170
Mailing Address - Country:US
Mailing Address - Phone:760-788-9725
Mailing Address - Fax:760-788-9754
Practice Address - Street 1:1012 MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:RAMONA
Practice Address - State:CA
Practice Address - Zip Code:92065-2170
Practice Address - Country:US
Practice Address - Phone:760-788-9725
Practice Address - Fax:760-788-9754
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65681106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist