MEDICARE: DR. RAYMOND FABIE MD

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	2084F0202X	Forensic Psychiatry Physician	G42773	CA
2	2084P0800X	Psychiatry Physician	G42773	CA
3	2084P0802X	Addiction Psychiatry Physician	G42773	CA
4	2084P0804X	Child & Adolescent Psychiatry Physician	G42773	CA
5	2084P0805X	Geriatric Psychiatry Physician	G42773	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00G427731	OTHER		PPIN

General Provider Information

NPI Number	:	1841382439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND FABIE MD

Provider Business Mailing Address
First Line	:	2001 THE ALAMEDA
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126-1136
Country	:	US
Telephone Number	:	408-261-7135
Fax Number	:	408-554-9960

Provider Business Practice Location Address
First Line	:	2001 THE ALAMEDA
Second Line	:	SERVICE TEAM A ALAMEDA
City	:	SAN JOSE
State	:	CA
Zip	:	95126-1136
Country	:	US
Telephone Number	:	408-261-7135
Fax Number	:	408-554-9960

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

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	09/11/2025

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