Provider Demographics
NPI:1912067844
Name:BRIOZA, DEBRA A (NA)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:BRIOZA
Suffix:
Gender:F
Credentials:NA
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 3033
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96160
Mailing Address - Country:US
Mailing Address - Phone:530-582-4977
Mailing Address - Fax:775-329-5563
Practice Address - Street 1:10098 JIBBOOM ST
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161
Practice Address - Country:US
Practice Address - Phone:530-582-4977
Practice Address - Fax:775-329-5563
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0528106H00000X
CA32314106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist