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NPI Code Detail

MEDICARE: BRIGHTMANE ENTERPRISES LLC

MEDICARE: BRIGHTMANE ENTERPRISES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1679420210
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIGHTMANE ENTERPRISES LLC
Provider Business Mailing Address
First Line : 440 N BARRANCA AVE # 5838
Second Line :
City : COVINA
State : CA
Zip : 91723-1722
Country : US
Telephone Number : 650-547-4826
Fax Number : 650-887-3206
Provider Business Practice Location Address
First Line : 1040 LINCOLN AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95125-3150
Country : US
Telephone Number : 650-547-4826
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : ALISHA ALLEN
Credential : LCSW
Telephone Number : 650-547-4826
Provider Enumeration Date : 03/12/2026
Last Update Date : 03/12/2026

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Directions to “BRIGHTMANE ENTERPRISES LLC ” Practice Location

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