Basic Information
| Provider Information | |||||||||
| NPI: | 1972838829 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROOKS | ||||||||
| FirstName: | DIONNE | ||||||||
| MiddleName: | PATRICE | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3467 SONOMA BLVD STE 10 | ||||||||
| Address2: | |||||||||
| City: | VALLEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945902922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7075522629 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1855 2ND ST STE B | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945192623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8552237123 | ||||||||
| FaxNumber: | 6193747134 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2009 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 25868 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.