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General NPI Number Information
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NPI Number | 1497648232
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Entity Type | Organization
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Legal Business Name | TRIVIUM DELTA PSYCHOLOGY GROUP PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 12/13/2025
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Provider Practice Location Address
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Address Line | 65 N RAYMOND AVE STE 330
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City | PASADENA
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State | CA
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Zip | 91103-3947
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Country | US
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Telephone | 626-208-9426
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Fax |
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Provider Business Mailing Address
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Address Line | 65 N RAYMOND AVE STE 330
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City | PASADENA
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State | CA
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Zip | 91103-3947
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | DR. BRIANNA STALEY SHUMAKER
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Credential | PHD, ABPP
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Telephone | 626-208-9426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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