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1790520443
ANDRE LEE MADSEN
SAN LEANDRO, CA
NPI
1790520443
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 16542-i)
Enumeration Date
2024-06-26
Last Update Date
2024-06-26
Business Address
Mr. ANDRE LEE MADSEN
2035 FAIRMONT DR
SAN LEANDRO, CA 94578-1088
Phone number: 866-866-7496
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Mailing Address
Mr. ANDRE LEE MADSEN
3210 62ND AVE
OAKLAND, CA 94605-1614
Phone number: 510-753-9524
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