Provider Demographics
NPI:1710455803
Name:HODNETT, BREAUNA CHANTE
Entity Type:Individual
Prefix:MS
First Name:BREAUNA
Middle Name:CHANTE
Last Name:HODNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4997 FARLEY ST
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-6990
Mailing Address - Country:US
Mailing Address - Phone:916-882-9594
Mailing Address - Fax:
Practice Address - Street 1:2167 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-4945
Practice Address - Country:US
Practice Address - Phone:530-538-2174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty