Provider Demographics
NPI:1407827389
Name:CONSIDINE, T BRENDAN (MFT)
Entity Type:Individual
Prefix:MR
First Name:T
Middle Name:BRENDAN
Last Name:CONSIDINE
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6425 GRANGERS DAIRY DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-1041
Mailing Address - Country:US
Mailing Address - Phone:916-424-5004
Mailing Address - Fax:
Practice Address - Street 1:660 FLORIN RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-2683
Practice Address - Country:US
Practice Address - Phone:916-612-7716
Practice Address - Fax:916-428-0312
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28970106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist