Healthcare Provider Details

I. General information

NPI: 1801620448
Provider Name (Legal Business Name): ASHLEY ELIZABETH BRUMETT PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20377 SW ACACIA ST STE 110
NEWPORT BEACH CA
92660-0781
US

IV. Provider business mailing address

851 DOMINGO DR APT 5
NEWPORT BEACH CA
92660-4524
US

V. Phone/Fax

Practice location:
  • Phone: 888-717-9355
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: