Provider Demographics
NPI:1811261373
Name:SATTERTHWAITE, BRIANNA (PSYD)
Entity type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:
Last Name:SATTERTHWAITE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27542
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-7542
Mailing Address - Country:US
Mailing Address - Phone:559-246-9766
Mailing Address - Fax:877-818-2250
Practice Address - Street 1:24863 W JAYNE AVE
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-9502
Practice Address - Country:US
Practice Address - Phone:559-246-9766
Practice Address - Fax:877-818-2250
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA PSY 20865103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist