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Individual

BRYAN LEE ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PPS

Contact information

Practice address
401 OLD SAN JOSE RD, SOQUEL, CA 95073-2299
(831) 429-3909
Mailing address
401 OLD SAN JOSE RD, SOQUEL, CA 95073-2299
(831) 429-3909

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
220243537
CA

Other

Enumeration date
10/29/2025
Last updated
10/29/2025
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