BRIAN LEE DOMITROVICH

OAKLAND, CA
NPI1467060798
Other NameRAQUEL AMBER SANTIAGO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy373H00000X Day Training/Habilitation Specialist
(Licence: CA  13534)
Additional Taxonomies101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  13534)
Enumeration Date2020-07-22
Last Update Date2026-04-07
Business Address
BRIAN LEE DOMITROVICH SUDCC II
280 17TH ST
OAKLAND, CA 94612-4124
Phone number: 510-238-5020
Mailing Address
BRIAN LEE DOMITROVICH SUDCC II
6649 FOOTHILL BLVD UNIT 2
OAKLAND, CA 94605-2018
Phone number: 415-318-0375