Individual
MR. BRIAN STANNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II
Contact information
Practice address
3767 CENTRAL AVE, SAN DIEGO, CA 92105-2599
(619) 584-4010
Mailing address
6235 LORCA DR, SAN DIEGO, CA 92115-5507
(619) 635-2590
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A062240323
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1312790618
CA
Other
Enumeration date
05/24/2019
Last updated
10/28/2024
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