Individual provider Active NPI

Jame'E Wiley Brazie'R, L.A.C. DAOM

  • Acupuncturist
  • San Mateo, CA
National Provider Identifier
1043565591
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC14050 Issued in CA
Practice address
215 N San Mateo Dr Ste 2
San Mateo, CA 94401-2674
Phone
(650) 980-5088
Fax
(800) 886-4813
NPI assigned
Jul 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 117797 CA
Acupuncturist 171100000X AC14050 CA Primary

Addresses

Primary practice location

215 N San Mateo Dr Ste 2
San Mateo, CA 94401-2674

Mailing address

215 N San Mateo Dr Ste 2
San Mateo, CA 94401-2674
Phone (650) 980-5088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
117797CAMDAcupuncturist
AC14050CAMDAcupuncturist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1043565591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N SAN MATEO DR STE 2",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012674",
            "telephone_number": "650-980-5088",
            "fax_number": "800-886-4813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N SAN MATEO DR STE 2",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012674",
            "telephone_number": "650-980-5088",
            "fax_number": "800-886-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZIE'R",
        "first_name": "JAME'E",
        "middle_name": "WILEY",
        "name_prefix": "Dr.",
        "credential": "L.A.C. DAOM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-20",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "117797",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC14050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.