Healthcare Provider Details

I. General information

NPI: 1255242285
Provider Name (Legal Business Name): SYMIL AUSTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 BLACKSTONE DR
SAN RAFAEL CA
94903-1401
US

IV. Provider business mailing address

380 NOVA ALBION WAY
SAN RAFAEL CA
94903-3523
US

V. Phone/Fax

Practice location:
  • Phone: 415-492-3741
  • Fax:
Mailing address:
  • Phone: 415-492-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: