Healthcare Provider Details

I. General information

NPI: 1780714675
Provider Name (Legal Business Name): JESSICA BRIT HOLT DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA BRIT D'AMICO DNP

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 11/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

889 PACIFIC ST
MONTEREY CA
93940
US

IV. Provider business mailing address

PO BOX 4797
BELFAST ME
04915
US

V. Phone/Fax

Practice location:
  • Phone: 831-649-0175
  • Fax: 831-646-0220
Mailing address:
  • Phone: 831-649-0175
  • Fax: 831-649-0220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN697980
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number17238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: