Provider Demographics
NPI:1528494820
Name:BROWNE, FREDERICK TYROME
Entity type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:TYROME
Last Name:BROWNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2083
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-0083
Mailing Address - Country:US
Mailing Address - Phone:206-601-3931
Mailing Address - Fax:
Practice Address - Street 1:1910 OLYMPIC BLVD
Practice Address - Street 2:STE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5096
Practice Address - Country:US
Practice Address - Phone:925-943-1794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
CAIMF 78295106H00000X
CA128871106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional