Provider Demographics
NPI:1982377099
Name:SIMPSON, BRIANNA JEANENE (MS)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:JEANENE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-3917
Mailing Address - Country:US
Mailing Address - Phone:805-242-1630
Mailing Address - Fax:
Practice Address - Street 1:1407 GARDEN ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3917
Practice Address - Country:US
Practice Address - Phone:805-242-1630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist