Individual provider · Type 1 NPI

Michelle Lane Phommachit

Addiction (Substance Use Disorder) Counselor · San Leandro, CA

NPI number 1326639956 Active

Practice location

2035 Fairmont Dr # Sr
San Leandro, CA 94578-1088

Call (866) 866-7496 Map

Mailing address

39663 Leslie St Apt 424
Fremont, CA 94538-2243

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X11468 (CA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1326639956

Michelle Lane Phommachit's National Provider Identifier is 1326639956, issued on Jan 27, 2021. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Leandro, CA. The record was last updated on Jan 27, 2021.