Provider Demographics
NPI:1922593318
Name:PIERCE, BREANNA BRESHAY
Entity Type:Individual
Prefix:
First Name:BREANNA
Middle Name:BRESHAY
Last Name:PIERCE
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 1:25455 WHITMAN ST APT 20
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-2476
Mailing Address - Country:US
Mailing Address - Phone:916-694-4373
Mailing Address - Fax:
Practice Address - Street 1:25455 WHITMAN ST APT 20
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-2476
Practice Address - Country:US
Practice Address - Phone:916-694-4373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst