Provider Demographics
NPI:1003167636
Name:CLINE, BRENDA DENISE (MFT, CADC II)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:DENISE
Last Name:CLINE
Suffix:
Gender:F
Credentials:MFT, CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1856
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-6856
Mailing Address - Country:US
Mailing Address - Phone:916-812-3488
Mailing Address - Fax:916-376-9479
Practice Address - Street 1:2829 WATT AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-6200
Practice Address - Country:US
Practice Address - Phone:916-482-1132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-22
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA3702695101YA0400X
CA52212106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)