Provider Demographics
NPI:1154710689
Name:BLEEKER, BRIANNA (PHD)
Entity type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:
Last Name:BLEEKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:
Other - Last Name:BENTLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16960 BASTANCHURY RD STE E
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-1711
Mailing Address - Country:US
Mailing Address - Phone:714-455-9234
Mailing Address - Fax:
Practice Address - Street 1:16960 BASTANCHURY RD STE E
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-1711
Practice Address - Country:US
Practice Address - Phone:714-455-9234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY32517103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical