Individual
BRIAN PHANICHKARN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
39180 LIBERTY ST STE 220, FREMONT, CA 94538-1522
(415) 735-4899
Mailing address
17247 VIA EL CERRITO, SAN LORENZO, CA 94580-2736
(415) 795-0737
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
90788
CA
Other
Enumeration date
09/08/2019
Last updated
09/28/2021
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