Individual
DR. BRIAN VANFOSSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3434 MIDWAY DR STE 2001, SAN DIEGO, CA 92110-4924
(619) 325-1161
(619) 325-1717
Mailing address
3434 MIDWAY DR STE 2001, SAN DIEGO, CA 92110-4924
(619) 325-1161
(619) 325-1717
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PY60013796
WA
103TC0700X
Clinical Psychologist
Primary
23462
CA
Other
Enumeration date
11/09/2009
Last updated
07/08/2021
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