Provider Demographics
NPI:1801817556
Name:TOLBERT, BRENDA E (MFT)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:E
Last Name:TOLBERT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9837 FOLSOM BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1356
Mailing Address - Country:US
Mailing Address - Phone:916-856-5700
Mailing Address - Fax:916-856-5708
Practice Address - Street 1:9837 FOLSOM BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1356
Practice Address - Country:US
Practice Address - Phone:916-856-5700
Practice Address - Fax:916-856-5708
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37299101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional