Provider Demographics
NPI:1831862135
Name:HARO, BRENDA ELIZABETH
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:ELIZABETH
Last Name:HARO
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 1:3855 N WEST AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93705-2759
Mailing Address - Country:US
Mailing Address - Phone:559-334-6433
Mailing Address - Fax:
Practice Address - Street 1:3855 N WEST AVE
Practice Address - Street 2:STE 105, 108, &110
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93705
Practice Address - Country:US
Practice Address - Phone:559-274-0299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-01
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373H00000X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health Worker
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Single Specialty