Individual
MR. BRIAN ALLAN DEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SUDRC
Contact information
Practice address
102 W BIANCHI RD, STOCKTON, CA 95207-7132
(209) 451-3628
Mailing address
102 W BIANCHI RD, STOCKTON, CA 95207-7132
(209) 451-3628
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/11/2024
Last updated
04/11/2024
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