Individual
SYED U. FAROOQ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9100 BRENTWOOD BLVD, BRENTWOOD, CA 94513-4000
(925) 809-7920
(925) 809-7928
Mailing address
9100 BRENTWOOD BLVD, BRENTWOOD, CA 94513-4000
(925) 809-7920
(925) 809-7928
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070024AN
STATE CERT-ANTIOCH
CA
01
—
070024BN
STATE CERT - BRENTWOOD
CA
01
—
070753
MASTER PROVIDER FILE NO
CA
01
—
0753
DRUG MEDI-CAL BILLING NO
CA
01
—
07531
ANTIOCH ADULT BILLING
CA
01
—
07533
ANTIOCH ADOL BILLING
CA
01
—
07551
BRENTWOOD ADULT BILLING
CA
01
—
07553
BRENTWOOD ADOL BILLING
CA
01
—
07555
DRUG CT BILLING
CA
01
—
07556
BYRON RANCH BILLING
CA
01
—
56679
STAFF ID NUMBER
CA
Enumeration date
05/03/2007
Last updated
07/08/2007
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