Individual
BRIAN SEVERNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RADT R1344310419
Contact information
Practice address
2218 N 1ST ST, SAN JOSE, CA 95131-2007
(408) 538-0893
Mailing address
2218 N 1ST ST, SAN JOSE, CA 95131-2007
(408) 538-0893
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1344310419
CA
Other
Enumeration date
04/26/2019
Last updated
04/26/2019
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