Healthcare Provider Details

I. General information

NPI: 1750217105
Provider Name (Legal Business Name): KOURTNEY LYNN HOLMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 G ST
BAKERSFIELD CA
93301-3929
US

IV. Provider business mailing address

2131 G ST
BAKERSFIELD CA
93301-3929
US

V. Phone/Fax

Practice location:
  • Phone: 661-327-4357
  • Fax: 661-327-1758
Mailing address:
  • Phone: 661-327-4357
  • Fax: 661-327-1758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310394
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: