NPI 1003011495

Douglas Brackmann, PHD

Practitioner Psychologist San Diego, CA

Practice location

Address: 3101 4th Ave, San Diego, CA 92103-5802
Phone: (858) 735-1667
Fax: (619) 542-0332
Mailing address: 8536 Ridgefield Pl, San Diego, CA 92129-3731

Registered specialties

Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103T00000X Licence PSY19753 (CA)

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Registry record

NPI: 1003011495
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Jun 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.