Provider Demographics
NPI:1598098246
Name:COAKLEY, BRENDA YVONNE (MSW)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:YVONNE
Last Name:COAKLEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:YVONNE
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:90 GREAT OAKS BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1314
Mailing Address - Country:US
Mailing Address - Phone:408-281-0708
Mailing Address - Fax:408-281-2658
Practice Address - Street 1:90 GREAT OAKS BLVD STE 108
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1314
Practice Address - Country:US
Practice Address - Phone:408-281-0708
Practice Address - Fax:408-281-2658
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health