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General NPI Number Information
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NPI Number | 1275833758
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Entity Type | Organization
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Legal Business Name | BRIGHTER HOPE PSYCHOLOGICAL SERVICES, INC
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Dates
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Enumeration Date | 10/29/2010
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Last Update Date | 10/29/2010
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Provider Practice Location Address
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Address Line | 1421 16TH ST FLOOR 2
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City | SACRAMENTO
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State | CA
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Zip | 95814-5003
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Country | US
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Telephone | 916-224-0212
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Fax | 916-415-7051
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Provider Business Mailing Address
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Address Line | 1421 16TH ST FLOOR 2
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City | SACRAMENTO
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State | CA
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Zip | 95814-5003
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Country | US
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Telephone | 916-224-0212
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Fax | 916-415-7051
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Authorized Official
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Title or Position | MANAGING PARTNER / PSYCHOLOGIST
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Name | DR. ANDREW MENDONSA
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Credential | PSY.D.
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Telephone | 916-224-0212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | H0501251418
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 502041328
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSB35143
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSB35429
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS17934
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS14541
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC44328
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY23208
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License Number State | CA
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