Individual
LISA BRENNEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2365 VIA SIENA, LA JOLLA, CA 92037-3933
(858) 761-6141
Mailing address
2365 VIA SIENA, LA JOLLA, CA 92037-3933
(858) 761-6141
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
95108134
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95108134
REGISTERED NURSE
CA
Enumeration date
11/02/2016
Last updated
11/02/2016
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