Individual
MR. BRAD K NYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
7355 CHURCH ST STE A, YUCCA VALLEY, CA 92284-3273
(949) 294-8627
Mailing address
7355 CHURCH ST STE A, YUCCA VALLEY, CA 92284-3273
(949) 294-8627
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
I-07957
NM
101YP2500X
Professional Counselor
X-06721
NM
1041C0700X
Clinical Social Worker
Primary
LCSW63280
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136275
—
CA
Enumeration date
09/25/2009
Last updated
05/31/2024
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