Dr Blake Brisbois, PSYD is a
Psychologist - Clinical based in Westlake Vlg, California. Dr Blake Brisbois is licensed to practice in California (license number PSY32519) and his current practice location is
2625 Townsgate Rd Ste 210, Westlake Vlg, California. He can be reached at his office (for appointments etc.) via phone at
(805) 497-0605.
NPI number for Dr Blake Brisbois is 1669826723 and his current mailing address is 2625 Townsgate Rd Ste 210, Westlake Vlg, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1669826723.
Healthcare Provider's Profile
| Full Name | Dr Blake Brisbois |
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| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 2625 Townsgate Rd Ste 210, Westlake Vlg, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1669826723
- Provider Enumeration Date: 04/14/2016
- Last Update Date: 06/08/2021
Medical Identifiers
Medical identifiers for Dr Blake Brisbois such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669826723 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 32519 (California) | Secondary |
| 103TC0700X | Psychologist - Clinical | PSY32519 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Blake Brisbois is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Blake Brisbois, PSYD
2625 Townsgate Rd Ste 210,
Westlake Vlg, CA 91361-5754
Ph: (805) 497-0605 | Dr Blake Brisbois, PSYD
2625 Townsgate Rd Ste 210,
Westlake Vlg, CA 91361-5754
Ph: (805) 497-0605 |
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