Individual
CARRIE L BRECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
100 PRISON RD, REPRESA, CA 95671-3000
(916) 985-8610
Mailing address
100 PRISON RD, REPRESA, CA 95671-3000
(916) 985-8610
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY22050
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY22050
CALIFORNIA PSYCHOLOGY LICENSE
CA
Enumeration date
10/27/2006
Last updated
06/13/2012
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