Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | A3702695 | CA |
NPI | 1003167636 |
---|---|
Provider Name | Brenda Denise Cline |
First Address | West Sacramento, CA 95691-6856 |
Second Address | Sacramento, CA 95821-6200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2012 |
Last Update Date | 11/02/2022 |