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General NPI Number Information
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NPI Number | 1982888533
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Entity Type | Individual
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Provider Name | BRIAN M CHICHESTER PSY.D., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 339 CAJON ST SUITE B
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City | REDLANDS
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State | CA
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Zip | 92373-5901
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Country | US
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Telephone | 909-363-6263
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Fax | 909-307-6536
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Provider Business Mailing Address
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Address Line | 339 CAJON ST SUITE B
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City | REDLANDS
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State | CA
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Zip | 92373-5901
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Country | US
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Telephone | 909-363-6263
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Fax | 909-307-6536
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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 | PSY 21544
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License Number State | CA
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