Individual
BRIAN PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1756 S LEWIS RD, CAMARILLO, CA 93012-8520
(805) 383-3669
Mailing address
818 SKYCREST CT, VENTURA, CA 93003-1203
(805) 383-3669
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174400000X
REHAB ACTIVITY LEADER
CA
Enumeration date
03/07/2011
Last updated
03/07/2011
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