Provider Demographics
NPI:1821635806
Name:HEBERT, BRITTNEY JACQUELENE (MA)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:JACQUELENE
Last Name:HEBERT
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 1:3880 S BASCOM AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-2675
Mailing Address - Country:US
Mailing Address - Phone:408-559-1115
Mailing Address - Fax:
Practice Address - Street 1:3880 S BASCOM AVE STE 202
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-2675
Practice Address - Country:US
Practice Address - Phone:408-559-1115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA127481101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health