Provider Demographics
NPI:1730942046
Name:BROWN, TERRY ANN
Entity type:Individual
Prefix:MS
First Name:TERRY
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 RACE ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-3130
Mailing Address - Country:US
Mailing Address - Phone:669-312-1832
Mailing Address - Fax:
Practice Address - Street 1:46 RACE ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3130
Practice Address - Country:US
Practice Address - Phone:669-312-1832
Practice Address - Fax:408-961-9853
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator