Provider Demographics
NPI:1083782684
Name:RENATA BROWNBRIDGE APC
Entity Type:Organization
Organization Name:RENATA BROWNBRIDGE APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:510-538-9130
Mailing Address - Street 1:6086 BELLINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-1629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:347 14TH STREET
Practice Address - Street 2:
Practice Address - City:MONTARA
Practice Address - State:CA
Practice Address - Zip Code:94037
Practice Address - Country:US
Practice Address - Phone:650-728-4550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALF0015631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty