Healthcare Provider Details

I. General information

NPI: 1710019823
Provider Name (Legal Business Name): DEBBIE HUNTER HOLTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

474 W VERMONT AVE STE 104
ESCONDIDO CA
92025-6584
US

IV. Provider business mailing address

1569 MADRID DR
VISTA CA
92081-5010
US

V. Phone/Fax

Practice location:
  • Phone: 760-432-9884
  • Fax: 760-432-9953
Mailing address:
  • Phone: 949-413-4742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number695408
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: