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General NPI Number Information
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NPI Number | 1295038727
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Entity Type | Individual
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Provider Name | SAMUEL A. BRUMIT MFT
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Gender | Male
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Dates
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Enumeration Date | 12/05/2010
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 1509 VIA DORADO
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City | SAN MARCOS
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State | CA
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Zip | 92069-3259
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Country | US
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Telephone | 760-975-5282
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Fax |
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Provider Business Mailing Address
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Address Line | 100 E SAN MARCOS BLVD STE 400
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City | SAN MARCOS
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State | CA
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Zip | 92069-2988
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Country | US
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Telephone | 760-975-5282
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Fax |
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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 | 33761
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License Number State | CA
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