Individual provider Active NPI

Antionette Denise Brookins

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1649330069
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
80890 Issued in CA
Practice address
3723 E Dakota Ave
Fresno, CA 93726-5106
Phone
(559) 709-9169
Fax
(559) 225-5369
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 80890 CA Primary

Addresses

Primary practice location

3723 E Dakota Ave
Fresno, CA 93726-5106

Mailing address

5275 N 1St St
Fresno, CA 93710-7007
Phone (559) 709-9169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
80890CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Antionette Brookins & Associates , Corp Marriage & Family Therapist CurrentSince Nov 3, 2024 Accepting new patients
Destination.Hope Counseling & Enrichment Center Marriage & Family Therapist CurrentSince Dec 15, 2019 Accepting new patients

Locations

5275 N 1st St
Fresno, CA 93710
Phone (559) 691-5831

3723 E Dakota Ave
Fresno, CA 93726
Phone (559) 709-9169

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1649330069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5275 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107007",
            "telephone_number": "559-709-9169",
            "fax_number": "559-225-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 E DAKOTA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937265106",
            "telephone_number": "559-709-9169",
            "fax_number": "559-225-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKINS",
        "first_name": "ANTIONETTE",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "80890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.