Healthcare Provider Details

I. General information

NPI: 1932838489
Provider Name (Legal Business Name): BRIGHTSIDE EDUCATIONAL EVALUATIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5352 GOOSEBERRY WAY
OCEANSIDE CA
92057-4629
US

IV. Provider business mailing address

5352 GOOSEBERRY WAY
OCEANSIDE CA
92057-4629
US

V. Phone/Fax

Practice location:
  • Phone: 619-368-5147
  • Fax:
Mailing address:
  • Phone: 619-368-5147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ARLEEN SILVA CONRADI
Title or Position: LICENSED EDUCATIONAL PSYCHOLOGIST
Credential: LEP 3697
Phone: 619-368-5147