Healthcare Provider Details

I. General information

NPI: 1821951328
Provider Name (Legal Business Name): BROOKE LORRAINE PETRICCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 AUBURN BLVD STE 100
SACRAMENTO CA
95821-2124
US

IV. Provider business mailing address

4508 FLORADALE CT
ROCKLIN CA
95677-4539
US

V. Phone/Fax

Practice location:
  • Phone: 916-300-6576
  • Fax:
Mailing address:
  • Phone: 916-390-8655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: