Individual
BRODERICK PURNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
22505 WOODROE AVE, HAYWARD, CA 94541-3410
(510) 537-1688
Mailing address
22505 WOODROE AVE, HAYWARD, CA 94541-3410
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/10/2016
Last updated
11/27/2017
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