Healthcare Provider Details

I. General information

NPI: 1285881151
Provider Name (Legal Business Name): MRS. JACINTA LALITA BROWN-WADE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2008
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 PLUMAS ST
YUBA CITY CA
95991-4437
US

IV. Provider business mailing address

809 PLUMAS ST
YUBA CITY CA
95991-4437
US

V. Phone/Fax

Practice location:
  • Phone: 530-822-7478
  • Fax:
Mailing address:
  • Phone: 530-822-7478
  • Fax:

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 Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLMFT103253
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: