Provider Demographics
NPI:1982126058
Name:DUNPHEY, BRIAN XAVIER
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:XAVIER
Last Name:DUNPHEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 OZETA TER
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-1835
Mailing Address - Country:US
Mailing Address - Phone:949-293-6725
Mailing Address - Fax:
Practice Address - Street 1:1271 OZETA TER
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90069-1835
Practice Address - Country:US
Practice Address - Phone:949-293-6725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96483106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist