Provider Demographics
NPI:1093524365
Name:HOLLAND, BRANDON DARION DANTRIEL
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:DARION DANTRIEL
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E 13TH STREET
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341
Mailing Address - Country:US
Mailing Address - Phone:209-385-7311
Mailing Address - Fax:
Practice Address - Street 1:301 E 13TH STREET
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341
Practice Address - Country:US
Practice Address - Phone:209-385-7311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker