Provider Demographics
NPI:1124738042
Name:BRYANT, VICTORIA ASHLEY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ASHLEY
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 DEL PASO RD STE 130-223
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-2305
Mailing Address - Country:US
Mailing Address - Phone:925-325-6815
Mailing Address - Fax:
Practice Address - Street 1:2701 DEL PASO RD STE 130-223
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95835-2305
Practice Address - Country:US
Practice Address - Phone:281-241-7509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA676231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical