Provider Demographics
NPI:1699471433
Name:GEDDINGS, BRENNA LEIGH
Entity type:Individual
Prefix:
First Name:BRENNA
Middle Name:LEIGH
Last Name:GEDDINGS
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 1:25636 SHARP DR APT C
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-4501
Mailing Address - Country:US
Mailing Address - Phone:951-892-6687
Mailing Address - Fax:
Practice Address - Street 1:25636 SHARP DR APT C
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-4501
Practice Address - Country:US
Practice Address - Phone:951-892-6687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician