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General NPI Number Information
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NPI Number | 1902345119
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Entity Type | Organization
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Legal Business Name | BRIAN DUNPHEY
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Dates
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Enumeration Date | 02/21/2017
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Last Update Date | 02/21/2017
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Provider Practice Location Address
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Address Line | 1850 N SAN CLEMENTE RD
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City | PALM SPRINGS
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State | CA
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Zip | 92262-3921
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Country | US
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Telephone | 959-293-6725
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Fax |
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Provider Business Mailing Address
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Address Line | 1850 N SAN CLEMENTE RD
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City | PALM SPRINGS
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State | CA
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Zip | 92262-3921
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Country | US
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Telephone | 949-293-6725
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR, THERAPIST
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Name | BRIAN X DUNPHEY
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Credential | MS JD
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Telephone | 949-293-6725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 96483
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License Number State | CA
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