MEDICARE: MS. DIANE CHRISTINE BRYSON

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
1	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1851221337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DIANE CHRISTINE BRYSON

Provider Business Mailing Address
First Line	:	20 BRENHAM CT
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-5576
Country	:	US
Telephone Number	:	916-380-1214
Fax Number	:	916-380-1214

Provider Business Practice Location Address
First Line	:	20 BRENHAM CT
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-5576
Country	:	US
Telephone Number	:	916-380-1214
Fax Number	:	916-380-1214

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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