MEDICARE: JEREMY LEE BROWNSTEIN L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	86276	CA

General Provider Information

NPI Number	:	1497182489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMY LEE BROWNSTEIN L.C.S.W.

Provider Business Mailing Address
First Line	:	1141 W SHAW AVE STE 203
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-3713
Country	:	US
Telephone Number	:	559-428-3176
Fax Number	:	559-475-8052

Provider Business Practice Location Address
First Line	:	1141 W SHAW AVE STE 203
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-3713
Country	:	US
Telephone Number	:	559-428-3176
Fax Number	:	559-475-8052

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2013
Last Update Date	:	08/15/2022

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