Provider Demographics
NPI:1467673509
Name:FAROOK, YOUSAF MOHAMMED (HEALTH EDUCATOR)
Entity Type:Individual
Prefix:
First Name:YOUSAF
Middle Name:MOHAMMED
Last Name:FAROOK
Suffix:
Gender:M
Credentials:HEALTH EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3686 HONDO ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105
Mailing Address - Country:US
Mailing Address - Phone:619-384-9335
Mailing Address - Fax:
Practice Address - Street 1:3686 HONDO ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105
Practice Address - Country:US
Practice Address - Phone:619-384-9335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACERTIFIED171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator