Provider Demographics
NPI:1922216340
Name:BLOOMFIELD, BRENDA J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:J
Last Name:BLOOMFIELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5335 COLLEGE AVE STE 27
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-2804
Mailing Address - Country:US
Mailing Address - Phone:510-655-7687
Mailing Address - Fax:510-655-7687
Practice Address - Street 1:5335 COLLEGE AVE STE 27
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-2804
Practice Address - Country:US
Practice Address - Phone:510-655-7687
Practice Address - Fax:510-655-7687
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS166781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical