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General NPI Number Information
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NPI Number | 1164153623
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Entity Type | Individual
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Provider Name | BROOKE ALEXANDRIA MCBAY
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Gender | Female
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 1910 ORANGE TREE LN STE 300
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City | REDLANDS
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State | CA
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Zip | 92374-4500
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Country | US
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Telephone | 909-474-2773
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 65
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City | PATTON
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State | CA
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Zip | 92369-0065
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Country | US
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Telephone | 951-956-3948
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 142920
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License Number State | CA
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