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1356127096
BRYAN DE JUSTIN
MODESTO, CA
NPI
1356127096
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-09-07
Last Update Date
2023-09-07
Business Address
BRYAN DE JUSTIN
1235 MCHENRY AVE SUITE #A & #B
MODESTO, CA 95350
Phone number: 209-527-4597
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Mailing Address
BRYAN DE JUSTIN
2704 MEDINAH WAY
MODESTO, CA 95355-9619
Phone number: 408-888-4587
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