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General NPI Number Information
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NPI Number | 1104118280
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Entity Type | Individual
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Provider Name | MELISSA BRYMER PH.D., PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/09/2011
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Last Update Date | 05/09/2011
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Provider Practice Location Address
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Address Line | 9401 WILSHIRE BLVD SUITE 730
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-2928
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Country | US
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Telephone | 310-562-0442
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Fax | 310-235-2612
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Provider Business Mailing Address
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Address Line | 4328 W 178TH ST
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City | TORRANCE
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State | CA
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Zip | 90504-3637
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Country | US
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Telephone | 310-562-0442
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Fax | 310-235-2612
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY18187
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSY18187
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License Number State | CA
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