Provider Demographics
NPI:1467209718
Name:FINK, BROOKE
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:FINK
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 1:2900 CAMINO DIABLO STE 100-3
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3999
Mailing Address - Country:US
Mailing Address - Phone:925-272-8607
Mailing Address - Fax:
Practice Address - Street 1:2900 CAMINO DIABLO STE 100-3
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-3999
Practice Address - Country:US
Practice Address - Phone:925-272-8607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140377106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist