Provider Demographics
NPI:1134348832
Name:BROWN, VICTORIA LYNNE (MFT)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:LYNNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 WEST 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-9540
Mailing Address - Country:US
Mailing Address - Phone:707-546-4673
Mailing Address - Fax:
Practice Address - Street 1:2235 CORPORATE CENTER PARKWAY
Practice Address - Street 2:#102
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-9540
Practice Address - Country:US
Practice Address - Phone:707-547-9797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT38773106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist