Individual
BRIANA JAYE BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15563 UNION AVE, LOS GATOS, CA 95032-3904
(408) 377-2020
Mailing address
338 E HAMILTON AVE, CAMPBELL, CA 95008-0207
(408) 866-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
34576
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
04/06/2020
Last updated
02/09/2021
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