Healthcare Provider Details

I. General information

NPI: 1306159918
Provider Name (Legal Business Name): MATTHEW JOEL BROOKS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2010
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date: 04/21/2021
Reactivation Date: 05/28/2021

III. Provider practice location address

2682 MOWRY AVE
FREMONT CA
94538-1619
US

IV. Provider business mailing address

1080 MONROE ST #120
ALBANY CA
94706
US

V. Phone/Fax

Practice location:
  • Phone: 510-248-8201
  • Fax: 510-248-8211
Mailing address:
  • Phone: 510-606-9485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number19992
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number19992
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: