Provider Demographics
NPI:1396107595
Name:BERRETT, BRIAN (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:BERRETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5190 NEIL RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6599
Mailing Address - Country:US
Mailing Address - Phone:775-784-4917
Mailing Address - Fax:775-784-1428
Practice Address - Street 1:5190 NEIL RD
Practice Address - Street 2:SUITE 215
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-784-4917
Practice Address - Fax:775-784-1428
Is Sole Proprietor?:No
Enumeration Date:2016-03-26
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12365803-12052084P0800X
CAA1552192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry