Basic Information
| Provider Information | |||||||||
| NPI: | 1285171702 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROOKS | ||||||||
| FirstName: | DARCI | ||||||||
| MiddleName: | |||||||||
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| OtherOrganizationName: | |||||||||
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| OtherLastName: | BROOKS | ||||||||
| OtherFirstName: | DARCI | ||||||||
| OtherMiddleName: | ANN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7000 FRANKLIN BLVD STE 625 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958231884 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163889418 | ||||||||
| FaxNumber: | 9163889273 | ||||||||
| Practice Location | |||||||||
| Address1: | 7000 FRANKLIN BLVD STE 625 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958231884 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163889418 | ||||||||
| FaxNumber: | 9163889273 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2017 | ||||||||
| LastUpdateDate: | 01/22/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.