Provider Demographics
NPI:1881159598
Name:BROWN, LEA DANANG (CADC II)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:DANANG
Last Name:BROWN
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 PAUL DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2023
Mailing Address - Country:US
Mailing Address - Phone:415-492-4444
Mailing Address - Fax:415-492-8844
Practice Address - Street 1:135 PAUL DR
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2023
Practice Address - Country:US
Practice Address - Phone:415-492-4444
Practice Address - Fax:415-492-8844
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA063471123101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)