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NPI Code Detail

MEDICARE: CHRYSHEA ELAINE BRYSON

MEDICARE: CHRYSHEA ELAINE 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
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1992433171
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRYSHEA ELAINE BRYSON
Provider Business Mailing Address
First Line : DEPT LA 22763, PASADENA CA 91185-2763
Second Line :
City : PASADENA
State : CA
Zip : 91185-2763
Country : US
Telephone Number : 866-523-4268
Fax Number :
Provider Business Practice Location Address
First Line : SOUTH BAY ( SAN JOSE) USE DEPT LA 22763 PASADENA CA
Second Line :
City : PASADENA
State : CA
Zip : 91185-0001
Country : US
Telephone Number : 866-523-4268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2022
Last Update Date : 08/15/2022

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Directions to “ CHRYSHEA ELAINE BRYSON ” Practice Location

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