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DR. SEAN P BRANNON PH.D., ABN
>> Clinical Neuropsychologist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1114178985
Individual Registrant:DR. SEAN P BRANNON PH.D., ABN
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
3102 E. HIGHLAND AVENUE MEDICAL STAFF OFFICE PATTON, CA 92369 US
Tel: 909-425-7679 Fax: 909-425-6635
Tel: 909-425-7679 Fax: 909-425-6635
Contact information for business:
3102 E. HIGHLAND AVENUE MEDICAL STAFF OFFICE PATTON, CA 92369 US
Tel: 909-425-7679 Fax: 909-425-6635
Tel: 909-425-7679 Fax: 909-425-6635
Registration Information:
NPI: 1114178985
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | CA | PSY21995 |
| N | 103TF0200X | Behavioral Health & Social Service Providers Psychologist | CA | PSY21995 |
| Y | 103TC0700X | Behavioral Health & Social Service Providers Psychologist | CA | 21995 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
