Provider Demographics
NPI:1962224543
Name:MESHKE MCLAY, BRIANNA (PHD, LEP)
Entity type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:
Last Name:MESHKE MCLAY
Suffix:
Gender:F
Credentials:PHD, LEP
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 4107
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92052-4107
Mailing Address - Country:US
Mailing Address - Phone:858-522-0272
Mailing Address - Fax:
Practice Address - Street 1:450 S MELROSE DR # 55
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6674
Practice Address - Country:US
Practice Address - Phone:858-522-0272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALEP4405103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool