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General NPI Number Information
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NPI Number | 1003951054
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Entity Type | Individual
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Provider Name | BRYAN JAMES LOYCE M.A., M.A.
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Gender | Male
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 04/28/2011
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Provider Practice Location Address
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Address Line | 2351 CARDINAL LN., ANNEX B
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City | SAN DIEGO
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State | CA
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Zip | 92123
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Country | US
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Telephone | 619-225-9621
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Fax | 619-225-9672
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Provider Business Mailing Address
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Address Line | PO BOX 23265
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City | SAN DIEGO
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State | CA
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Zip | 92193-3265
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Country | US
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Telephone | 714-393-4793
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Fax | 619-225-9672
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF55119
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License Number State | CA
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