Individual
BREANNA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
711 E MAIN ST, QUINCY, CA 95971-9722
(530) 283-3960
Mailing address
711 E MAIN ST, QUINCY, CA 95971-9722
(530) 283-3960
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ASW84584
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ASW84584
ASSOC. CLINICAL SOCIAL WORKER
CA
Enumeration date
02/01/2019
Last updated
10/04/2019
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