Brian T Reynolds, SUDCC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

291 Smith Ranch Rd
San Rafael, CA 94903-2093

Phone

(415) 492-0818

NPI assigned

May 6, 2024

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Helen Vine Recovery Center

  • Substance Abuse Rehabilitation Facility
  • San Rafael, CA
  • NPI 1003206228
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1639926645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 CORBY AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954076108",
            "telephone_number": "707-293-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 SMITH RANCH RD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032093",
            "telephone_number": "415-492-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "BRIAN",
        "middle_name": "T",
        "credential": "SUDCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Marie Renton, NP
• Heather Ann Renz, NP RN CNM
• Ann Reppun, NP RN
• Elisa J Reubens
• Emma Reulbach
• Holly Reynolds
• Jeana Luree Reynolds, MFT
• Dorota Krystyna Rhoads, M.D.
• David Rhyoo, PHARMD
• Duncan Andrew Riach, M.A.

• Addiction (Substance Use Disorder) Counselor in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.