Individual
DR. JESSICA A. BROMMELHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
622 JEANETTE LN, SANTA ANA, CA 92705-6020
(203) 675-2597
Mailing address
622 JEANETTE LN, SANTA ANA, CA 92705-6020
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY25383
CA
103TC0700X
Clinical Psychologist
PSY25383
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB232248
MEDICARE ID
CA
Enumeration date
01/22/2015
Last updated
01/21/2016
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