Healthcare Provider Details

I. General information

NPI: 1841382439
Provider Name (Legal Business Name): RAYMOND FABIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 THE ALAMEDA SERVICE TEAM A ALAMEDA
SAN JOSE CA
95126-1136
US

IV. Provider business mailing address

2001 THE ALAMEDA
SAN JOSE CA
95126-1136
US

V. Phone/Fax

Practice location:
  • Phone: 408-261-7135
  • Fax: 408-554-9960
Mailing address:
  • Phone: 408-261-7135
  • Fax: 408-554-9960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberG42773
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG42773
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberG42773
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG42773
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberG42773
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: