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Individual

MR. BRIAN JOHN DUNGAO MALICDEM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3607 MAIN ST, SUITE A, FREMONT, CA 94538-4390
(510) 226-6180
Mailing address
1024 SUMMERDALE DR, SAN JOSE, CA 95132-2932
(408) 921-7004

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
104100000X
Social Worker
Primary

Other

Enumeration date
12/01/2008
Last updated
09/08/2016
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