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NPI Code Detail

MEDICARE: JORGE ALEJANDRO BRICENO

MEDICARE: JORGE ALEJANDRO BRICENO
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
1106H00000XMarriage & Family TherapistMFT104716CA

General Provider Information

NPI Number : 1710311980
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE ALEJANDRO BRICENO
Provider Business Mailing Address
First Line : PO BOX 711492
Second Line :
City : SAN DIEGO
State : CA
Zip : 92171-1492
Country : US
Telephone Number : 858-432-3245
Fax Number :
Provider Business Practice Location Address
First Line : 8880 RIO SAN DIEGO DR STE 800
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1642
Country : US
Telephone Number : 858-432-3245
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2013
Last Update Date : 05/04/2026

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Directions to “ JORGE ALEJANDRO BRICENO ” Practice Location

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