Individual ProviderBrian Eugene GreenSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1684 E 14th St Ste 207, San Leandro, CA 94577-4800(415) 652-8214PECOS EnrollmentBased on the most recent information from CMS, provider Brian Eugene Green does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1912607532Provider TypeIndividualFull NameGreen, Brian EugeneCredentialDAOM, LCSW, L.ACGenderMaleSole ProprietorYesEnumeration Date3/3/2023Last Updated3/3/2023Contact InformationPractice LocationPractice Address1684 E 14th St Ste 207, San Leandro, CA 94577-4800Phone(415) 652-8214FaxUnlisted FaxMailing LocationMailing Address1684 E 14th St Ste 207, San Leandro, CA 94577-4800Phone(415) 652-8214FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense29891CaliforniaCode171100000XDescriptionAcupuncturistOther Service ProvidersLicense16841California