Provider Demographics
NPI:1164665402
Name:BROWN, NATHANIEL ANTHONY (BSW)
Entity Type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:ANTHONY
Last Name:BROWN
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5445 E BELMONT AVE APT 274
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-2682
Mailing Address - Country:US
Mailing Address - Phone:559-431-6476
Mailing Address - Fax:
Practice Address - Street 1:4944 E CLINTON WAY STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1527
Practice Address - Country:US
Practice Address - Phone:559-251-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)