Individual
DR. BLAKE BRISBOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
2625 TOWNSGATE RD STE 210, WESTLAKE VLG, CA 91361-5754
(805) 497-0605
(805) 371-4862
Mailing address
2625 TOWNSGATE RD STE 210, WESTLAKE VLG, CA 91361-5754
(805) 497-0605
(805) 371-4862
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
32519
CA
103TC0700X
Clinical Psychologist
Primary
PSY32519
CA
Other
Enumeration date
04/14/2016
Last updated
06/08/2021
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