Healthcare Provider Details

I. General information

NPI: 1831862135
Provider Name (Legal Business Name): BRENDA ELIZABETH HARO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3855 N WEST AVE STE 105, 108, &110
FRESNO CA
93705
US

IV. Provider business mailing address

1690 W SHAW AVE STE 201
FRESNO CA
93711-3519
US

V. Phone/Fax

Practice location:
  • Phone: 559-274-0299
  • Fax:
Mailing address:
  • Phone: 559-334-6442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number140121
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: