Individual
CHARISE HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1671 THE ALAMEDA STE 306, SAN JOSE, CA 95126-2222
(408) 966-6564
Mailing address
1613 DAISY TREE, CERES, CA 95307-9599
(510) 571-9739
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
174400000X
Specialist
Primary
—
—
Other
Enumeration date
04/04/2019
Last updated
12/02/2022
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