Provider Demographics
NPI:1891363784
Name:BROWN, MARANDA ALISE
Entity Type:Individual
Prefix:MS
First Name:MARANDA
Middle Name:ALISE
Last Name:BROWN
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 1:1724 VISTA VERDE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-4187
Mailing Address - Country:US
Mailing Address - Phone:530-680-6258
Mailing Address - Fax:
Practice Address - Street 1:88 TABLE MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-3578
Practice Address - Country:US
Practice Address - Phone:530-538-2158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty