Provider Demographics
NPI:1336285568
Name:BRUGNANO, JACLIN (MFT)
Entity Type:Individual
Prefix:MS
First Name:JACLIN
Middle Name:
Last Name:BRUGNANO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 COHASSET RD STE 120
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2282
Mailing Address - Country:US
Mailing Address - Phone:530-894-5933
Mailing Address - Fax:530-592-0500
Practice Address - Street 1:260 COHASSET RD STE 120
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2282
Practice Address - Country:US
Practice Address - Phone:530-894-5933
Practice Address - Fax:530-592-0500
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT30537106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist