Breanna Raquelle Cruz
Counselor, Addiction (Substance Use Disorder) in Clearlake Oaks, CA. Individual provider (NPI-1).
NPI number1689246746
StatusActive
Last updated in NPPESJul 20, 2021
Details
- NPI
- 1689246746
- Entity type
- Individual (NPI-1)
- Name
- Breanna Raquelle Cruz
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 16, 2021
- Certification date
- Jul 20, 2021
- Last updated
- Jul 20, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
Other names
- Breanna Raquelle Ahart (Former Name)
Practice location
14715 Hwy 20Clearlake Oaks, CA 95423
Phone 707-998-1800 · Fax 707-998-0122
Mailing address
Po Box 366Clearlake Oaks, CA 95423-0366
Phone 707-349-8897
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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- Pete Kavanaugh, SUDRC15061NPI 1649974759
All 18 Addiction (Substance Use Disorder) Counselor providers in Clearlake Oaks · All 41 providers in Clearlake Oaks
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