Individual
BRIAN BOGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1931 CENTER ST, BERKELEY, CA 94704-1105
(510) 666-9552
(510) 666-0987
Mailing address
1931 CENTER ST, BERKELEY, CA 94704-1105
(510) 666-9552
(510) 666-0987
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00
00
CA
Enumeration date
02/12/2018
Last updated
02/12/2018
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