Healthcare Provider Details

I. General information

NPI: 1568885366
Provider Name (Legal Business Name): CHELSEY RENE HOLZER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 E PALMDALE BLVD
PALMDALE CA
93550-4750
US

IV. Provider business mailing address

1050 E PALMDALE BLVD
PALMDALE CA
93550-4750
US

V. Phone/Fax

Practice location:
  • Phone: 661-208-4699
  • Fax: 661-208-4761
Mailing address:
  • Phone: 661-208-4699
  • Fax: 661-208-4761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: