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General NPI Number Information
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NPI Number | 1285192096
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Entity Type | Organization
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Legal Business Name | ANTIONETTE BROOKINS & ASSOCIATES , CORP
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 3723 E DAKOTA AVE
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City | FRESNO
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State | CA
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Zip | 93726-7007
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Country | US
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Telephone | 559-709-9169
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Fax |
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Provider Business Mailing Address
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Address Line | 7081 N MARKS AVE #104 PMB 184
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City | FRESNO
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State | CA
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Zip | 93711-7007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, CLINICAL DIRECTOR
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Name | MRS. ANTIONETTE DENISE BROOKINS
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Credential | LMFT
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Telephone | 559-709-9169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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