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General NPI Number Information
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NPI Number | 1194015958
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Entity Type | Individual
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Provider Name | JENNIFER HOLLAND BROWN PSYD
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Gender | Female
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 06/22/2016
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Provider Practice Location Address
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Address Line | 621 CHERRY ST
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City | SANTA ROSA
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State | CA
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Zip | 95404-4202
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Country | US
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Telephone | 707-479-2946
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Fax | 707-792-3900
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Provider Business Mailing Address
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Address Line | 621 CHERRY ST
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City | SANTA ROSA
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State | CA
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Zip | 95404-4202
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Country | US
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Telephone | 707-479-2946
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Fax | 707-792-3900
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY21675
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License Number State | CA
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