Individual
MR. CARROLL TAYLOR BROWN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
652 PETALUMA AVE STE H, SEBASTOPOL, CA 95472-4266
(707) 823-3166
(707) 869-8170
Mailing address
468 STOW AVE APT 3, OAKLAND, CA 94606-1159
(510) 934-2805
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
95202301
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95018200
CA
Other
Enumeration date
08/05/2020
Last updated
03/20/2024
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