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NPI Code Detail

MEDICARE: DIONNE PATRICE BROOKS LCSW

MEDICARE: DIONNE PATRICE BROOKS 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
11041C0700XClinical Social Worker25868CA

General Provider Information

NPI Number : 1972838829
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIONNE PATRICE BROOKS LCSW
Provider Business Mailing Address
First Line : 3467 SONOMA BLVD STE 10
Second Line :
City : VALLEJO
State : CA
Zip : 94590-2922
Country : US
Telephone Number : 707-552-2629
Fax Number :
Provider Business Practice Location Address
First Line : 1855 2ND ST STE B
Second Line :
City : CONCORD
State : CA
Zip : 94519-2623
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2009
Last Update Date : 03/17/2018

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Directions to “ DIONNE PATRICE BROOKS LCSW” Practice Location

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