Provider Demographics
NPI:1396803730
Name:SENA, BROOKE LEIGH (LMFT, MBA)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:LEIGH
Last Name:SENA
Suffix:
Gender:F
Credentials:LMFT, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 801
Mailing Address - Street 2:
Mailing Address - City:FOREST RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:95942-0801
Mailing Address - Country:US
Mailing Address - Phone:530-570-1221
Mailing Address - Fax:
Practice Address - Street 1:370 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3404
Practice Address - Country:US
Practice Address - Phone:530-570-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC45274106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC 45274OtherMFT