Most Relevant Information
Provider Data
| NPI Number: | 1003011495 |
| Provider Name: | DOUGLAS BRACKMANN PH.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 103T00000X |
| Specialty: | Psychologist |
| License Number: | PSY19753 |
Most Important Dates
| Enumeration Date: | 06/18/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
3101 4TH AVE
SAN DIEGO
CA
921035802
Practice Location Phone/Fax
| Phone: | 8587351667 |
| Fax: | 6195420332 |
Provider Mailing Location
8536 RIDGEFIELD PL
SAN DIEGO
CA
921293731
Provider Mailing Phone/Fax
| Phone: | 8587351667 |
| Fax: | 6195420332 |