Healthcare Provider Details

I. General information

NPI: 1225753932
Provider Name (Legal Business Name): HOLLY BRIGGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2022
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19322 JESSE LN STE 200
RIVERSIDE CA
92508-5072
US

IV. Provider business mailing address

PO BOX 1452
SAN JACINTO CA
92581-1452
US

V. Phone/Fax

Practice location:
  • Phone: 951-387-4040
  • Fax:
Mailing address:
  • Phone: 951-442-9805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: