Individual
MRS. JUDY BRISENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
161 VALHALLA CT, 5063 MIDWAY RD, VACAVILLE, CA 95687-6225
(707) 678-5614
(707) 678-4690
Mailing address
5063 MIDWAY RD, VACAVILLE, CA 95688-9697
(707) 678-5614
(707) 678-4690
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT22322
CA
Other
Enumeration date
12/20/2006
Last updated
07/08/2007
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