Individual
BRETT FAGREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1403 164TH AVE, SAN LEANDRO, CA 94578-3123
(510) 481-8645
Mailing address
25125 SANTA CLARA ST # 128, HAYWARD, CA 94544-2165
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/25/2007
Last updated
07/08/2007
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