Healthcare Provider Details

I. General information

NPI: 1902949910
Provider Name (Legal Business Name): DONNA RETTA BROWN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DONNA RETTA BROWN LMFT

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1965 LIVE OAK BLVD
YUBA CITY CA
95991-8850
US

IV. Provider business mailing address

1965 LIVE OAK BLVD
YUBA CITY CA
95961
US

V. Phone/Fax

Practice location:
  • Phone: 530-822-7200
  • Fax: 530-822-3296
Mailing address:
  • Phone: 530-822-7200
  • Fax: 530-822-3296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC5969
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number198585
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT141254
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCI02920315
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: