Individual
MR. BRUCE ARLEN BENHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RADT
Contact information
Practice address
603 D ST, SAN RAFAEL, CA 94901-3719
(415) 454-9444
(415) 454-4864
Mailing address
603 D ST, SAN RAFAEL, CA 94901-3719
(415) 454-9444
(415) 454-4864
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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