Basic Information
Provider Information
NPI: 1346260627
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROOKS-KAYAL
FirstName: AMY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4860 Y ST STE 3700
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958172307
CountryCode: US
TelephoneNumber: 9167346285
FaxNumber: 9167346525
Practice Location
Address1: 3160 FOLSOM BLVD STE 2100
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958165266
CountryCode: US
TelephoneNumber: 9167343588
FaxNumber: 9164512010
Other Information
ProviderEnumerationDate: 07/20/2006
LastUpdateDate: 12/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0402XC170839CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology

No ID Information.


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