Individual
DR. BRANDON S PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2100 NAPA VALLEJO HWY, NAPA, CA 94558-6234
(707) 253-5000
(707) 253-5513
Mailing address
1600 9TH STREET, ROOM 205 MAILSTOP 2-3, SACRAMENTO, CA 95814-6414
(916) 654-2431
(916) 654-3186
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
Primary
PSY24096
CA
Other
Enumeration date
04/15/2010
Last updated
06/20/2011
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