BRIAN LEE DOMITROVICH

OAKLAND, CA
NPI1467060798
Other NameRAQUEL AMBER SANTIAGO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  13534)
Enumeration Date2020-07-22
Last Update Date2024-01-05
Business Address
BRIAN LEE DOMITROVICH SUDCC
2577 SAN PABLO AVE
OAKLAND, CA 94612-1159
Phone number: 510-466-6100
Mailing Address
BRIAN LEE DOMITROVICH SUDCC
6649 FOOTHILL BLVD UNIT 2
OAKLAND, CA 94605-2018
Phone number: 415-318-0375