MEDICARE: GENEVIEVE BRINK-CAPRIOLA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker
2	1041C0700X	Clinical Social Worker	LCS 15642	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LCS 15642	OTHER	CA	STATE LICENSE

General Provider Information

NPI Number	:	1760604367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GENEVIEVE BRINK-CAPRIOLA LCSW

Provider Business Mailing Address
First Line	:	128 ZINNIA WAY
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95926-5201
Country	:	US
Telephone Number	:	530-680-6923
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 ILAHEE LN STE 150
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95973-7205
Country	:	US
Telephone Number	:	530-876-3174
Fax Number	:	530-876-2183

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	06/03/2024

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