Provider Demographics
NPI:1750412102
Name:HOLDING, ANNE BROADUS (LMFT)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:BROADUS
Last Name:HOLDING
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 N. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ALTURAS
Mailing Address - State:CA
Mailing Address - Zip Code:96101
Mailing Address - Country:US
Mailing Address - Phone:530-233-6312
Mailing Address - Fax:
Practice Address - Street 1:441 NORTH MAIN ST
Practice Address - Street 2:---
Practice Address - City:ALTURAS
Practice Address - State:CA
Practice Address - Zip Code:96101-4113
Practice Address - Country:US
Practice Address - Phone:530-233-6312
Practice Address - Fax:530-233-6339
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF99575101YM0800X
CA123367106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health