Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY 25423 | CA |
Y | 103G00000X | Clinical Psychologist | PSY 25423 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY 25423 | CA |
N | 103TC1900X | Counseling Psychologist | PSY 25423 | CA |
N | 103TF0000X | Family Psychologist | PSY 25423 | CA |
NPI | 1144410200 |
---|---|
Provider Name | Dr. Jaime Humberto Brown JR. |
First Address | La Puente, CA 91744-4853 |
Second Address | Brea, CA 92821-5786 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 18/11/2020 |