Provider Demographics
NPI:1063793727
Name:BROWNING, TOM CHARLES (CAS I)
Entity type:Individual
Prefix:MR
First Name:TOM
Middle Name:CHARLES
Last Name:BROWNING
Suffix:
Gender:M
Credentials:CAS I
Other - Prefix:MR
Other - First Name:TOM
Other - Middle Name:CHARLES
Other - Last Name:BROWNING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CAS I
Mailing Address - Street 1:603 D ST
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3719
Mailing Address - Country:US
Mailing Address - Phone:415-454-9444
Mailing Address - Fax:
Practice Address - Street 1:603 D ST
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3719
Practice Address - Country:US
Practice Address - Phone:415-454-9444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA03070494101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA101YA041XOtherSUBSTANCE ABUSE