Provider Demographics
NPI:1942955984
Name:BROOKINS, AJA
Entity Type:Individual
Prefix:
First Name:AJA
Middle Name:
Last Name:BROOKINS
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:PO BOX 2463
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95812-2463
Mailing Address - Country:US
Mailing Address - Phone:916-701-3774
Mailing Address - Fax:
Practice Address - Street 1:1244 NORTH AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-3634
Practice Address - Country:US
Practice Address - Phone:916-701-3774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date: