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General NPI Number Information
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NPI Number | 1306213509
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Entity Type | Individual
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Provider Name | DEBORAH KIMBERLY BRYK LPCC
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Gender | Female
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Dates
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Enumeration Date | 08/24/2015
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 8950 VILLA LA JOLLA DR STE C230
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City | LA JOLLA
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State | CA
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Zip | 92037-1712
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Country | US
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Telephone | 925-282-1778
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Fax | 415-296-5299
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Provider Business Mailing Address
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Address Line | 8950 VILLA LA JOLLA DR STE C230
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City | LA JOLLA
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State | CA
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Zip | 92037-1712
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Country | US
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Telephone | 925-282-1778
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Fax | 415-296-5299
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPCC15041
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License Number State | CA
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