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Individual

MR. BRIAN NEAL GREENLEAF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CADC II

Contact information

Practice address
44359 PALM ST, INDIO, CA 92201-3116
(760) 342-6616
(760) 342-8073
Mailing address
44359 PALM ST, INDIO, CA 92201-3116
(760) 342-6616
(760) 342-8073

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
A063790224
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1881788503
MEDI-CAL
CA
Enumeration date
03/28/2019
Last updated
02/12/2024
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