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General NPI Number Information
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NPI Number | 1376695528
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Entity Type | Individual
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Provider Name | JOHN M BROWN PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 02/01/2016
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Provider Practice Location Address
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Address Line | 1330 LINCOLN AVE STE 309
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City | SAN RAFAEL
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State | CA
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Zip | 94901-2143
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Country | US
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Telephone | 415-755-3596
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Fax |
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Provider Business Mailing Address
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Address Line | 1459 18TH ST # 213
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-2801
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Country | US
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Telephone | 415-755-3596
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY27587
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License Number State | CA
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