Individual
BRIAN KEITH WOLFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
627 GRANT ST, VALLEJO, CA 94590-7228
(707) 553-1042
Mailing address
1045 GEORGE ST #B, VALLEJO, CA 94590
(707) 246-1689
(707) 553-8146
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10467
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67574
—
CA
Enumeration date
04/29/2020
Last updated
04/29/2020
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