Provider Demographics
NPI:1760140792
Name:SONYA BREWER PSYCHOTHERAPY GROUP, PC
Entity Type:Organization
Organization Name:SONYA BREWER PSYCHOTHERAPY GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:510-496-6010
Mailing Address - Street 1:1505 SOLANO AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2106
Mailing Address - Country:US
Mailing Address - Phone:510-496-6010
Mailing Address - Fax:
Practice Address - Street 1:1505 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94707-2106
Practice Address - Country:US
Practice Address - Phone:510-496-6010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)