Provider Demographics
NPI:1033441365
Name:HALLETT, BRENDA (BSW)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:
Last Name:HALLETT
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:VAN DYKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 GOVERNORS LN
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-5515
Mailing Address - Country:US
Mailing Address - Phone:530-520-7575
Mailing Address - Fax:
Practice Address - Street 1:7 GOVERNORS LN
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-5515
Practice Address - Country:US
Practice Address - Phone:530-520-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health