Active NPI
Corinne Brodnicki, M.A. LMFT
- Marriage & Family Therapist
- Roseville, CA
National Provider Identifier
1669724506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 1212 Coloma Way Ste D
Roseville, CA 95661-4646 - Phone
- (916) 407-4711
- NPI assigned
- Oct 2, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | CA | Primary |
Addresses
Primary practice location
1212 Coloma Way Ste D
Roseville, CA 95661-4646
Mailing address
1212 Coloma Way Ste D
Roseville, CA 95661-4646
Phone (916) 407-4711
Other practice location 1
2750 Sutterville Rd # Cottage2
Sacramento, CA 95820-1024
Phone (916) 290-8149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 30, 2025 through Jul 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85494 | CA | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542585600000",
"number": "1669724506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 COLOMA WAY STE D",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956614646",
"telephone_number": "916-407-4711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 COLOMA WAY STE D",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956614646",
"telephone_number": "916-407-4711"
}
],
"practiceLocations": [
{
"address_1": "2750 Sutterville Rd # Cottage2",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "958201024",
"country_code": "US",
"telephone_number": "916-290-8149",
"fax_number": "916-456-4636",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRODNICKI",
"first_name": "CORINNE",
"credential": "M.A. LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-02",
"last_updated": "2018-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.