Healthcare Provider Details

I. General information

NPI: 1841074747
Provider Name (Legal Business Name): HOLIDAY HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 AUBURN BLVD STE 100
SACRAMENTO CA
95821-2124
US

IV. Provider business mailing address

15734 CARRIE DR
GRASS VALLEY CA
95949-6571
US

V. Phone/Fax

Practice location:
  • Phone: 916-300-6576
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number251S00000X
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number151883
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: