Provider Demographics
NPI:1083050769
Name:BROOKS, DEENA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEENA
Middle Name:M
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 LA JOLLA VILLAGE DR.
Mailing Address - Street 2:C/O VA HEALTHCARE SYSTEM - SWS 122
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92161
Mailing Address - Country:US
Mailing Address - Phone:858-646-2852
Mailing Address - Fax:
Practice Address - Street 1:3350 LA JOLLA VILLAGE DR.
Practice Address - Street 2:C/O VA HEALTHCARE SYSTEM - SWS 122
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161
Practice Address - Country:US
Practice Address - Phone:858-646-2852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS284671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical