Individual
BREANNA MARIE HOLLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(619) 212-0655
Mailing address
740 BAYLOR AVE, BONITA, CA 91902-4031
(619) 212-0655
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
36036
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/03/2021
Last updated
07/31/2025
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