Provider Demographics
NPI:1790734606
Name:BRENNAN-COOKE, JESSE (MA)
Entity Type:Individual
Prefix:MS
First Name:JESSE
Middle Name:
Last Name:BRENNAN-COOKE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 SANTA RITA RD
Mailing Address - Street 2:SUITE #226
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-4746
Mailing Address - Country:US
Mailing Address - Phone:925-485-4601
Mailing Address - Fax:
Practice Address - Street 1:1811 SANTA RITA RD
Practice Address - Street 2:SUITE #226
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-4746
Practice Address - Country:US
Practice Address - Phone:925-485-4601
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 34157106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist