Individual
BRANDON MICHAEL ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAS
Contact information
Practice address
125 E DAKOTA AVE APT 104, FRESNO, CA 93704-4073
(559) 375-5487
Mailing address
125 E DAKOTA AVE APT 104, FRESNO, CA 93704-4073
(559) 375-5487
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
02-075241
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02-075241
CAARR
CA
Enumeration date
12/28/2006
Last updated
12/28/2007
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