Provider Demographics
NPI:1336867969
Name:ATWOOD, BRETT ANTHONY
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:ANTHONY
Last Name:ATWOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3348 PASEO NUEVO ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95838-5106
Mailing Address - Country:US
Mailing Address - Phone:530-753-2566
Mailing Address - Fax:
Practice Address - Street 1:1109 CHESTNUT LN
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-1302
Practice Address - Country:US
Practice Address - Phone:530-753-2566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor