Individual
BRYAN B. PORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
2046 LINCOLN ST # 2, BERKELEY, CA 94709-2018
(510) 883-1847
Mailing address
2046 LINCOLN ST # 2, BERKELEY, CA 94709-2018
(510) 883-1847
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY19116
CA
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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