Jamelia La-Kenya Brown, SUDCC IV
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · San Pablo, CA
NPI 1053039677 · NPPES record last updated Aug 22, 2022
Key facts
- NPI
- 1053039677
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 7619 (CA)
- Practice address
- 2089 Vale Rd Ste 14
San Pablo, CA 94806-3848 - Phone
- (510) 880-7145
- NPI assigned
- Aug 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 7619 | CA | Yes |
Addresses
Primary practice location
2089 Vale Rd Ste 14
San Pablo, CA 94806-3848
Mailing address
2089 Vale Rd Ste 14
San Pablo, CA 94806-3848
Phone (510) 880-7145
Other providers in San Pablo, CA
- Alexandra Elisabeth Brewster
- Sarah Romanow Briand
- Brookside Community Health Center
- Brookside Community Health Center, Inc
- Brookvale Medical Center Pharmacy
- Ahsabi-Monique L Burris
- Monica Adriana Bush
- Ronald Caballero
- Louise Cacatian
- Richard Caccamo
All providers in San Pablo, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.