Healthcare Provider Details

I. General information

NPI: 1225575673
Provider Name (Legal Business Name): BRENDA LY TORRES CARABALLO AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2017
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 ARNOLD DR STE 170
MARTINEZ CA
94553-6537
US

IV. Provider business mailing address

1320 ARNOLD DR STE 170
MARTINEZ CA
94553-6537
US

V. Phone/Fax

Practice location:
  • Phone: 925-839-0313
  • Fax:
Mailing address:
  • Phone: 925-839-0313
  • Fax: 925-387-8606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF140436
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: