Individual provider · NPI-1

Darlicia Tiffany Bruner

Day Training/Habilitation Specialist · San Leandro, CA

NPI number1174283733
StatusActive
Last updated in NPPESJul 6, 2025

Details

NPI
1174283733
Entity type
Individual (NPI-1)
Name
Darlicia Tiffany Bruner
Sex
Female
Sole proprietor
No
Enumeration date
Dec 23, 2021
Certification date
Jul 6, 2025
Last updated
Jul 6, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
373H00000X Day Training/Habilitation Specialist––Yes
101Y00000X Counselor––
101YM0800X Counselor, Mental Health––
106H00000X Marriage & Family TherapistAMFT146417CA

Practice location

400 Estudillo Ave
San Leandro, CA 94577-4999

Phone 510-924-0548

Mailing address

400 Estudillo Ave
San Leandro, CA 94577-4999

Phone 510-924-0548

Other practice locations

136 Valdivia Cir
San Ramon, CA 94583-2228

Phone 925-752-2083

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