Provider Demographics
NPI:1932253440
Name:BRYAN, JOHN B II (MFTI)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:B
Last Name:BRYAN
Suffix:II
Gender:M
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30182 MILANO RD
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-1670
Mailing Address - Country:US
Mailing Address - Phone:951-551-7907
Mailing Address - Fax:
Practice Address - Street 1:30182 MILANO RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-1670
Practice Address - Country:US
Practice Address - Phone:951-551-7907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44869106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist