Provider Demographics
NPI:1750501888
Name:BROWN, AISHA TARAE
Entity Type:Individual
Prefix:MS
First Name:AISHA
Middle Name:TARAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3151 LA SELVA ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-2171
Mailing Address - Country:US
Mailing Address - Phone:510-689-9899
Mailing Address - Fax:
Practice Address - Street 1:1380 HOWARD ST FL 1
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2638
Practice Address - Country:US
Practice Address - Phone:415-503-4734
Practice Address - Fax:415-255-3629
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)