Provider Demographics
NPI:1992116545
Name:BROOKS-DAVIS, NAKIESHA (MS, ATC)
Entity type:Individual
Prefix:
First Name:NAKIESHA
Middle Name:
Last Name:BROOKS-DAVIS
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 HILLTOP DR APT 215
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94806-5784
Mailing Address - Country:US
Mailing Address - Phone:510-326-9787
Mailing Address - Fax:
Practice Address - Street 1:185 HAAS PAVILION
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94720-0001
Practice Address - Country:US
Practice Address - Phone:510-326-9787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer