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1710400916
RANDY BROCKMAN
REDWOOD CITY, CA
NPI
1710400916
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-07-19
Last Update Date
2017-07-19
Business Address
Mr. RANDY BROCKMAN CAADE 1711108
609 PRICE AVE
REDWOOD CITY, CA 94063-1463
Phone number: 650-591-9623
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Mailing Address
Mr. RANDY BROCKMAN CAADE 1711108
610 ELM ST STE 212
SAN CARLOS, CA 94070-3070
Phone number:
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