Provider Demographics
NPI:1336490242
Name:BRIGHTEN, JOLENE KATHERINE (ND)
Entity type:Individual
Prefix:DR
First Name:JOLENE
Middle Name:KATHERINE
Last Name:BRIGHTEN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-2037
Mailing Address - Country:US
Mailing Address - Phone:510-985-4044
Mailing Address - Fax:
Practice Address - Street 1:3515 GRAND AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-2037
Practice Address - Country:US
Practice Address - Phone:510-985-4044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA601175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath