Provider Demographics
NPI:1801025333
Name:BRUBAKER, MEGAN ELAINE (MS, MFT, MED)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELAINE
Last Name:BRUBAKER
Suffix:
Gender:F
Credentials:MS, MFT, MED
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:CADWELL-BRUBAKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, MFT, MED
Mailing Address - Street 1:1050 TRUMPET VINE LN
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-5188
Mailing Address - Country:US
Mailing Address - Phone:925-659-5816
Mailing Address - Fax:
Practice Address - Street 1:1050 TRUMPET VINE LN
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94582-5188
Practice Address - Country:US
Practice Address - Phone:925-659-5816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240170086103TS0200X
CAMFC 50708106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist