Provider Demographics
NPI:1740650936
Name:ARROYO, BRENDA LEE (SUDCC-1)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LEE
Last Name:ARROYO
Suffix:
Gender:F
Credentials:SUDCC-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 COHASSET RD STE 130
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-5403
Mailing Address - Country:US
Mailing Address - Phone:530-552-4610
Mailing Address - Fax:530-879-3823
Practice Address - Street 1:3211 COHASSET RD STE 130
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-5403
Practice Address - Country:US
Practice Address - Phone:530-552-4610
Practice Address - Fax:530-879-3823
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
CA13024101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00Other00