Provider Demographics
NPI:1578838355
Name:BREZING, STACEY DIANE (MS, ACSM-RCEP)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:DIANE
Last Name:BREZING
Suffix:
Gender:F
Credentials:MS, ACSM-RCEP
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:DIANE
Other - Last Name:STREUBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ACSM-RCEP
Mailing Address - Street 1:1 SHIELDS AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-5270
Mailing Address - Country:US
Mailing Address - Phone:530-752-9651
Mailing Address - Fax:
Practice Address - Street 1:1 SHIELDS AVE
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-5270
Practice Address - Country:US
Practice Address - Phone:530-752-9651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist