Provider Demographics
NPI:1215501606
Name:BRIERLEY, JAKE M (MD)
Entity type:Individual
Prefix:DR
First Name:JAKE
Middle Name:M
Last Name:BRIERLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:317 BODEM ST
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-6106
Mailing Address - Country:US
Mailing Address - Phone:661-466-6523
Mailing Address - Fax:
Practice Address - Street 1:1320 CELESTE DR
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2402
Practice Address - Country:US
Practice Address - Phone:209-527-6900
Practice Address - Fax:209-524-7328
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA197893207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine