Individual
BRIAN EUGENE LANDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
155 WILLOWBROOK DR, BEN LOMOND, CA 95005-9714
(831) 336-5196
Mailing address
155 WILLOWBROOK DR, BEN LOMOND, CA 95005-9714
(831) 336-5196
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44AZ
MEDI/CAL PRV NBR
CA
Enumeration date
05/06/2013
Last updated
05/06/2013
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