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Individual

RAELYNN BRISTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD BCBA

Contact information

Practice address
8186 QUEENSLAND CT, SACRAMENTO, CA 95829-6551
(415) 870-3454
Mailing address
8186 QUEENSLAND CT, SACRAMENTO, CA 95829-6551

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103G00000X
Clinical Neuropsychologist
Primary
103K00000X
Behavior Analyst

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1548409410
NPI
CA
Enumeration date
10/25/2016
Last updated
10/25/2016
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