Provider Demographics
NPI:1356732648
Name:BREWER, ANN-ALECIA LORRAINE
Entity type:Individual
Prefix:
First Name:ANN-ALECIA
Middle Name:LORRAINE
Last Name:BREWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2719
Mailing Address - Country:US
Mailing Address - Phone:916-835-6718
Mailing Address - Fax:
Practice Address - Street 1:9412 BIG HORN BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-1101
Practice Address - Country:US
Practice Address - Phone:916-281-1691
Practice Address - Fax:916-226-2804
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW636291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical