Healthcare Provider Details

I. General information

NPI: 1306139944
Provider Name (Legal Business Name): VICTORIA MARGARINE HOLMES PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2011
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8282 SIERRA AVE UNIT 197
FONTANA CA
92334-7009
US

IV. Provider business mailing address

8282 SIERRA AVE UNIT 197
FONTANA CA
92334-7009
US

V. Phone/Fax

Practice location:
  • Phone: 909-413-6304
  • Fax:
Mailing address:
  • Phone: 909-413-6304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY36567
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: