Provider Demographics
NPI:1790865525
Name:BRENNAN, DEBRA ANN (MFT MARRIAGE & FAMIL)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ANN
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:MFT MARRIAGE & FAMIL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 MENDOCINO AVENUE
Mailing Address - Street 2:SUITE #6
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401
Mailing Address - Country:US
Mailing Address - Phone:707-578-8845
Mailing Address - Fax:707-578-8845
Practice Address - Street 1:920 MENDOCINO AVENUE
Practice Address - Street 2:SUITE #6
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401
Practice Address - Country:US
Practice Address - Phone:707-578-8845
Practice Address - Fax:707-578-8845
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT34079106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist