Healthcare Provider Details

I. General information

NPI: 1669334728
Provider Name (Legal Business Name): TISHOUNA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 HOWE AVE STE 700
SACRAMENTO CA
95825-4641
US

IV. Provider business mailing address

730 HOWE AVE STE 700
SACRAMENTO CA
95825-4641
US

V. Phone/Fax

Practice location:
  • Phone: 916-713-2154
  • Fax:
Mailing address:
  • Phone: 916-713-2154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: