Provider Demographics
NPI:1043859804
Name:BROWN, CHRISTOPHER STEVEN (COTA)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:STEVEN
Last Name:BROWN
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 NEWBURY ST
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-4836
Mailing Address - Country:US
Mailing Address - Phone:925-819-6261
Mailing Address - Fax:
Practice Address - Street 1:14766 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-4220
Practice Address - Country:US
Practice Address - Phone:510-352-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4957224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty