Provider Demographics
NPI:1053113605
Name:HARRIS, BRANDI E
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:E
Last Name:HARRIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 HULEN PL
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-2606
Mailing Address - Country:US
Mailing Address - Phone:909-452-0824
Mailing Address - Fax:
Practice Address - Street 1:2840 HULEN PL
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-2606
Practice Address - Country:US
Practice Address - Phone:951-318-6917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker