Goudelock, Bryan Kieth

Goudelock, Bryan Kieth is an individual health care provider with primary practice located at 11201 Benton St , Loma Linda CA 92357-1000. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Goudelock, Bryan Kieth can be contacted via phone (909) 825-7084.

Contact Information

Primary practice address
11201 Benton St Loma Linda CA 92357-1000
Phone: (909) 825-7084
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X

Profile Details

NPI number 1467649202
LBN Legal business name Goudelock, Bryan Kieth
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2007
Last updated Sep 25th, 2007 - about 18 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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