MEDICARE: MS. BRENDA E. TOLBERT MFT

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
1	101YP2500X	Professional Counselor	MFC37299	CA

General Provider Information

NPI Number	:	1801817556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRENDA E. TOLBERT MFT

Provider Business Mailing Address
First Line	:	9837 FOLSOM BLVD
Second Line	:	SUITE F
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-1356
Country	:	US
Telephone Number	:	916-856-5700
Fax Number	:	916-856-5708

Provider Business Practice Location Address
First Line	:	9837 FOLSOM BLVD
Second Line	:	SUITE F
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-1356
Country	:	US
Telephone Number	:	916-856-5700
Fax Number	:	916-856-5708

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/08/2007

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