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General NPI Number Information
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NPI Number | 1699018143
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Entity Type | Individual
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Provider Name | BRITTANY GREENBAUM PHD
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Gender |
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 1611 S MELROSE DR STE A162
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City | VISTA
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State | CA
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Zip | 92081-5407
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Country | US
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Telephone | 319-359-7103
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 S MELROSE DR STE A162
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City | VISTA
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State | CA
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Zip | 92081-5407
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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 |
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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 | 105550
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 34004
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License Number State | CA
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