Provider Demographics
NPI:1780348680
Name:HOLMES, BRANDI SM (ND)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:SM
Last Name:HOLMES
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3290 LUNA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-1725
Mailing Address - Country:US
Mailing Address - Phone:310-971-6191
Mailing Address - Fax:
Practice Address - Street 1:3290 LUNA AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-1725
Practice Address - Country:US
Practice Address - Phone:310-971-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND1298175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath