Provider Demographics
NPI:1174386361
Name:BRUEGGEMAN, LECHELLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:LECHELLE
Middle Name:
Last Name:BRUEGGEMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30211 AVENIDA DE LAS BANDERA STE 200
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2159
Mailing Address - Country:US
Mailing Address - Phone:949-409-5142
Mailing Address - Fax:
Practice Address - Street 1:30211 AVENIDA DE LAS BANDERA STE 200
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-2159
Practice Address - Country:US
Practice Address - Phone:949-409-5142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program