Provider Demographics
NPI:1598840092
Name:FAAS, BRIGITTE (DC)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:
Last Name:FAAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 4TH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3347
Mailing Address - Country:US
Mailing Address - Phone:415-258-0303
Mailing Address - Fax:415-721-7660
Practice Address - Street 1:523 4TH ST STE 206
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3347
Practice Address - Country:US
Practice Address - Phone:415-258-0303
Practice Address - Fax:415-721-7660
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14019111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0140190Medicare ID - Type Unspecified
U55594Medicare UPIN