Brison-Moll, Nancy Lynn

Brison-Moll, Nancy Lynn is an sole proprietor health care provider with primary practice located at 965 E Yosemite Ave Ste 12 , Manteca CA 95336-5944. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Brison-Moll, Nancy Lynn can be contacted via phone (209) 483-4498.

Contact Information

Primary practice address
965 E Yosemite Ave Ste 12 Manteca CA 95336-5944
Phone: (209) 483-4498
Fax: (209) 824-0010
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY 15243 California
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY15243 California

Profile Details

NPI number 1053410878
LBN Legal business name Brison-Moll, Nancy Lynn
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 21st, 2006
Last updated Apr 4th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053410878 NPPES
California MEDICAID 5088836

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