Healthcare Provider Details

I. General information

NPI: 1265916183
Provider Name (Legal Business Name): KIRBEE BROOKS MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 09/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 BECK AVE # MS 5-240
FAIRFIELD CA
94533-6804
US

IV. Provider business mailing address

275 BECK AVE # MS 5-240
FAIRFIELD CA
94533-6804
US

V. Phone/Fax

Practice location:
  • Phone: 707-784-8164
  • Fax: 707-421-6618
Mailing address:
  • Phone: 707-784-8164
  • Fax: 707-421-6618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: