Provider Demographics
NPI:1467545186
Name:HOLLANDER, FRED MARTIN
Entity Type:Individual
Prefix:MR
First Name:FRED
Middle Name:MARTIN
Last Name:HOLLANDER
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 1:148 RIVIERA CIR
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1505
Mailing Address - Country:US
Mailing Address - Phone:707-322-1226
Mailing Address - Fax:415-924-3154
Practice Address - Street 1:832 SCHOOL ST
Practice Address - Street 2:SUITE #3
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2828
Practice Address - Country:US
Practice Address - Phone:707-322-1226
Practice Address - Fax:415-924-8805
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 35282106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist