Healthcare Provider Details

I. General information

NPI: 1124818315
Provider Name (Legal Business Name): BRITE PSYCHOLOGICAL SERVICES, APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 05/09/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 S RANDOLPH AVE STE 165
BREA CA
92821-5786
US

IV. Provider business mailing address

265 S RANDOLPH AVE STE 165
BREA CA
92821-5786
US

V. Phone/Fax

Practice location:
  • Phone: 714-582-2149
  • Fax: 714-544-1473
Mailing address:
  • Phone: 714-582-2149
  • Fax: 714-544-1473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TJ PUNCHARD
Title or Position: PSYCHOLOGICAL ASSOCIATE
Credential: M.A., M.A.
Phone: 657-222-0857