Individual
BREANNA RAQUELLE CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14715 HWY 20, CLEARLAKE OAKS, CA 95423
(707) 998-1800
(707) 998-0122
Mailing address
PO BOX 366, CLEARLAKE OAKS, CA 95423-0366
(707) 349-8897
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/16/2021
Last updated
07/20/2021
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