Provider Demographics
NPI:1669124145
Name:HOUDESHELL, BRIEN JOSEPH (RADT)
Entity type:Individual
Prefix:MR
First Name:BRIEN
Middle Name:JOSEPH
Last Name:HOUDESHELL
Suffix:
Gender:M
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30227 HASLEY CANYON RD
Mailing Address - Street 2:
Mailing Address - City:CASTAIC
Mailing Address - State:CA
Mailing Address - Zip Code:91384-3212
Mailing Address - Country:US
Mailing Address - Phone:661-425-8168
Mailing Address - Fax:
Practice Address - Street 1:22722 SOLEDAD CANYON RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-2629
Practice Address - Country:US
Practice Address - Phone:661-425-8168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)