Doctor Name: | MR. BRIAN AUGUSTUS BINGHAM |
NPI Number: | 1003943218 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MHA |
License Number: | |
Business Practice Address: | 2275 Arlington Dr San Leandro, CA - 945781132 |
Business Phone Number: | 5104811222 |
Business Fax Number: | |
Mailing Address: | 420 Central Ave Apt 301, ALAMEDA |
State: | CA |
Postal Code: | 945013656 |
Phone Number: | 5104811222 |
Fax Number: | |
NPI Enumeration Date: | 02/27/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |