Provider Demographics
NPI:1861700403
Name:WROBEL, BRONWYN LEE (CA 83314 LH 60822228)
Entity type:Individual
Prefix:MRS
First Name:BRONWYN
Middle Name:LEE
Last Name:WROBEL
Suffix:
Gender:F
Credentials:CA 83314 LH 60822228
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-3311
Mailing Address - Country:US
Mailing Address - Phone:510-482-2244
Mailing Address - Fax:
Practice Address - Street 1:2200 6TH AVE STE 606
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1849
Practice Address - Country:US
Practice Address - Phone:510-497-1774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83314106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist