Provider Demographics
NPI:1225375397
Name:JUAREZ, BRANDI SUE (MA LMFT)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:SUE
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3929 HILLGROVE WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-2803
Mailing Address - Country:US
Mailing Address - Phone:916-206-7784
Mailing Address - Fax:
Practice Address - Street 1:8037 FAIR OAKS BLVD STE 110
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-6742
Practice Address - Country:US
Practice Address - Phone:916-206-7784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71187106H00000X
CA86121106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist