Provider Demographics
NPI:1023484102
Name:BRYAND, VANESSA MICHELLE (BA)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:MICHELLE
Last Name:BRYAND
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1171 HOMESTEAD RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-5478
Mailing Address - Country:US
Mailing Address - Phone:408-320-2590
Mailing Address - Fax:
Practice Address - Street 1:1171 HOMESTEAD RD
Practice Address - Street 2:SUITE 250
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-5478
Practice Address - Country:US
Practice Address - Phone:408-320-2590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator