Provider Demographics
NPI:1992257570
Name:PASILLAS, BRIANNA MICHELLE (RADT)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MICHELLE
Last Name:PASILLAS
Suffix:
Gender:F
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E. NEWLOVE DR.
Mailing Address - Street 2:APT. E
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454
Mailing Address - Country:US
Mailing Address - Phone:805-980-8815
Mailing Address - Fax:
Practice Address - Street 1:222 CARMEN LN STE 201
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-7777
Practice Address - Country:US
Practice Address - Phone:805-980-5193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)