Healthcare Provider Details

I. General information

NPI: 1780588798
Provider Name (Legal Business Name): BRANDON ANDREW LOZANO PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8880 RIO SAN DIEGO DR STE 800
SAN DIEGO CA
92108-1642
US

IV. Provider business mailing address

8880 RIO SAN DIEGO DR STE 800
SAN DIEGO CA
92108-1642
US

V. Phone/Fax

Practice location:
  • Phone: 619-485-5678
  • Fax: 619-789-1235
Mailing address:
  • Phone: 619-485-5678
  • Fax: 619-789-1235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number36981
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: