Provider Demographics
NPI:1245665561
Name:BREILING, CAROL LOUISE (PSYD, CATC-V, AMFT)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:LOUISE
Last Name:BREILING
Suffix:
Gender:F
Credentials:PSYD, CATC-V, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2635 KOKANEE WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-1912
Mailing Address - Country:US
Mailing Address - Phone:707-365-8008
Mailing Address - Fax:
Practice Address - Street 1:137 N COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-6646
Practice Address - Country:US
Practice Address - Phone:530-341-7543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94026604103TF0200X, 103TA0700X, 103TR0400X
101Y00000X, 101YA0400X, 390200000X
CA124395101YM0800X
CAAMFT124395106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAMFT124395Medicaid
CAPSB94026604Medicaid