Individual
MR. ANDRE LEE MADSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2035 FAIRMONT DR, SAN LEANDRO, CA 94578-1088
(866) 866-7496
Mailing address
3210 62ND AVE, OAKLAND, CA 94605-1614
(510) 753-9524
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16542-I
CA
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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