Individual
BRANDON WAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1501 IMPERIAL AVE, SAN DIEGO, CA 92101-7638
(619) 233-8500
Mailing address
PO BOX 928532, SAN DIEGO, CA 92192-8532
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
83457
CA
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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