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General NPI Number Information
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NPI Number | 1043186349
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Entity Type | Individual
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Provider Name | MICHAEL LEON BRIGHAM BA
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Gender | Male
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 3701 HACIENDA ST
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City | SAN MATEO
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State | CA
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Zip | 94403-4366
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Country | US
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Telephone | 650-539-0340
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Fax |
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Provider Business Mailing Address
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Address Line | 2105 ROYAL DR APT 2
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City | SANTA CLARA
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State | CA
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Zip | 95050-3660
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Country | US
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Telephone | 408-318-4370
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State | CA
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