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Leeroy Wainwright
Addiction (Substance Use Disorder) Counselor in San Pablo, California
NPI 1154713766

Leeroy Wainwright is an Addiction (Substance Use Disorder) Counselor based in San Pablo, CA and is specialized in Addiction (Substance Use Disorder). Leeroy Wainwright practices in San Pablo, CA. The NPI Number for Leeroy Wainwright is 1154713766 and holds a License No. (California).

The current practice location address for Leeroy Wainwright is 1515 Market Ave, San Pablo, CA and can be reached out via phone at 510-232-7571.

Location: 1515 Market Ave, San Pablo, CA, 94806-4357
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1154713766
Provider Name
Leeroy Wainwright
Credential
Provider Entity Type
Individual
Gender
Male
Address
1515 Market Ave, San Pablo, CA, 94806-4357
Phone Number
510-232-7571
Fax Number
Provider Enumeration Date
02/19/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1265560130 05 CA
institution
Provider Business Practice Location Address Details
Address
1515 Market Ave
City
San Pablo
State
California
Zip
94806-4357
Phone Number
510-232-7571
Fax Number
person
Provider Business Mailing Address Details
Address
1515 Market Ave
City
San Pablo
State
California
Zip
94806-4357
Phone Number
510-232-7571
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
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