Provider Demographics
NPI:1053604421
Name:FOSTER, BROOKE ANN (PSYD)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:ANN
Last Name:FOSTER
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:RENFROE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4216 S MOONEY BLVD # 305
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-9143
Mailing Address - Country:US
Mailing Address - Phone:559-702-3920
Mailing Address - Fax:
Practice Address - Street 1:4216 S MOONEY BLVD # 305
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-9143
Practice Address - Country:US
Practice Address - Phone:559-702-3922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25265103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist