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NPI Code Detail

MEDICARE: DR. ABBY MARIE BREWER-JOHNSON PSY.D.

MEDICARE: DR. ABBY MARIE BREWER-JOHNSON PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TA0400XAddiction (Substance Use Disorder) Psychologist
2103TA0700XAdult Development & Aging PsychologistPSY21142CA
3103TC0700XClinical PsychologistPSY21142CA
4103TC2200XClinical Child & Adolescent PsychologistPSY21142CA
5103TP2701XGroup Psychotherapy PsychologistPSY21142CA

General Provider Information

NPI Number : 1346321742
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ABBY MARIE BREWER-JOHNSON PSY.D.
Provider Business Mailing Address
First Line : 3101 FOURTH AVENUE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92024
Country : US
Telephone Number : 858-220-9666
Fax Number : 619-542-0332
Provider Business Practice Location Address
First Line : 3101 4TH AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-5802
Country : US
Telephone Number : 858-220-9666
Fax Number : 619-542-0332
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 09/11/2025

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