Active NPI
Eddie Lee Brown Jr.
- Counselor
- San Jose, CA
National Provider Identifier
1619487543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1887 Monterey Hwy Ste 205
San Jose, CA 95112 - Phone
- (408) 971-9822
- NPI assigned
- Oct 5, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary | ||
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
1887 Monterey Hwy Ste 205
San Jose, CA 95112
Mailing address
1887 Monterey Hwy Ste 205
San Jose, CA 95112-6192
Phone (408) 971-9822
Other practice location 1
115 Roundtable Dr Apt 13
San Jose, CA 95111-4145
Phone (713) 935-6859
Other practice location 2
115 Roundtable Dr Apt 13
San Jose, CA 95111-4145
Phone (713) 935-6859
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542326400000",
"number": "1619487543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1887 MONTEREY HWY STE 205",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951126192",
"telephone_number": "408-971-9822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1887 MONTEREY HWY STE 205",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95112",
"telephone_number": "408-971-9822"
}
],
"practiceLocations": [
{
"address_1": "115 Roundtable Dr Apt 13",
"address_purpose": "LOCATION",
"city": "San Jose",
"state": "CA",
"postal_code": "951114145",
"country_code": "US",
"telephone_number": "713-935-6859",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "115 Roundtable Dr Apt 13",
"address_purpose": "LOCATION",
"city": "San Jose",
"state": "CA",
"postal_code": "951114145",
"country_code": "US",
"telephone_number": "713-935-6859",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROWN",
"first_name": "EDDIE",
"middle_name": "LEE",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-05",
"last_updated": "2018-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.