BRIAN LEE DOMITROVICH RAC NPI 1467060798

NPI Information

NPI: 1467060798
Provider Name: BRIAN LEE DOMITROVICH, RAC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
2577 SAN PABLO AVE
OAKLAND, CA
ZIP 94612
Phone: (510) 466-6100
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Brian Lee Domitrovich, RAC is an addiction (substance use disorder) counselor in Oakland, CA. Brian Lee Domitrovich, RAC NPI is 1467060798. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2577 SAN PABLO AVE
OAKLAND, CA
ZIP 94612-159
Phone: (510) 466-6100

The enumeration date for this NPI number is 7/22/2020 and was last updated on 7/29/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	R1432670621	CALIFORNIA	Yes
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	14138-RAC	CALIFORNIA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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