Bryan B. Port is a Clinical in Berkeley, California. Bryan B. Port practices all healthcare services and medical treatments related to Clinical. The NPI Number for Bryan B. Port is 1124041280. The last update date is 2007-07-08.
Bryan B. Port's current location address is 2046 Lincoln St # 2, Berkeley, California. You can contact this provider via phone number 5108831847. The mailing address for Bryan B. Port is 2046 Lincoln St # 2, Berkeley, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bryan B. Port |
|---|---|
| Address | 2046 Lincoln St # 2, Berkeley, California |
| Phone Number | 5108831847 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1124041280 |
|---|---|
| Provider Enumeration Date | 2006-07-26 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2046 Lincoln St # 2 |
|---|---|
| City | Berkeley |
| State | California (CA) |
| Post Code | 947092018 |
| Phone Number | 5108831847 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PSY19116 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique 10-digit identification code issued to Bryan B. Port by the Centers for Medicare & Medicaid Services?
The Bryan B. Port has been assigned the NPI (National Provider Identifier) 1124041280 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Where is the Bryan B. Port located?
The Bryan B. Port is located at 2046 Lincoln St # 2, Berkeley, CA 947092018.
What is Bryan B. Port's specialized field of practice, and what is the corresponding taxonomy classification code?
The Bryan B. Port's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1124041280 to Bryan B. Port?
The Centers for Medicare & Medicaid Services assigned the 1124041280 to Bryan B. Port on 2006-07-26.
As of what date were the details related to Bryan B. Port most recently updated or revised?
The information pertaining to Bryan B. Port, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
NPI Number: 1245233907
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