Provider Demographics
NPI:1760604367
Name:BRINK-CAPRIOLA, GENEVIEVE (LCSW)
Entity type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:
Last Name:BRINK-CAPRIOLA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 ZINNIA WAY
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-5201
Mailing Address - Country:US
Mailing Address - Phone:530-680-6923
Mailing Address - Fax:
Practice Address - Street 1:15 ILAHEE LN STE 150
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-7205
Practice Address - Country:US
Practice Address - Phone:530-876-3174
Practice Address - Fax:530-876-2183
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
CALCS 156421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS 15642OtherSTATE LICENSE