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Individual

AMNESTY LEONA BRADLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
390 40TH ST, OAKLAND, CA 94609-2633
(510) 247-8235
Mailing address
2820 CLARENCE LN, FAIRFIELD, CA 94533-7106
(707) 419-1052

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CA

Other

Enumeration date
05/10/2019
Last updated
05/10/2019
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