Healthcare Provider Details

I. General information

NPI: 1386562866
Provider Name (Legal Business Name): MS. HOLLISTER ELKHART NAKAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 AUBURN RAVINE RD STE G
AUBURN CA
95603-3930
US

IV. Provider business mailing address

PO BOX 6346
AUBURN CA
95604-6346
US

V. Phone/Fax

Practice location:
  • Phone: 530-748-8764
  • Fax:
Mailing address:
  • Phone: 530-748-8764
  • Fax: 530-888-8767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: