Provider Demographics
NPI:1750644845
Name:BRINT, DONNA JEAN (AFMT, CAODC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:BRINT
Suffix:
Gender:F
Credentials:AFMT, CAODC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 SIERRA COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5768
Mailing Address - Country:US
Mailing Address - Phone:530-273-9541
Mailing Address - Fax:530-273-7740
Practice Address - Street 1:180 SIERRA COLLEGE DR
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5768
Practice Address - Country:US
Practice Address - Phone:530-273-9541
Practice Address - Fax:530-273-7740
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6372101YA0400X
CA101090106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)