Breanna Raquelle Cruz

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Clearlake Oaks, CA

NPI 1689246746 · NPPES record last updated Jul 20, 2021

Key facts

NPI
1689246746
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
14715 Hwy 20
Clearlake Oaks, CA 95423
Phone
(707) 998-1800
Fax
(707) 998-0122
NPI assigned
Jul 16, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Hilltop Recovery Services Current
since Jul 25, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

14715 Hwy 20
Clearlake Oaks, CA 95423

Mailing address

PO Box 366
Clearlake Oaks, CA 95423-0366
Phone (707) 349-8897

Other names

  • Breanna Raquelle Ahart Former name

Other providers in Clearlake Oaks, CA

All providers in Clearlake Oaks, CA · Addiction (Substance Use Disorder) Counselor in California

Sources for this page

Verify at the official NPI Registry.