Healthcare Provider Details

I. General information

NPI: 1538535919
Provider Name (Legal Business Name): DR. EMILY HOLMES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1936 DEL PASO RD
SACRAMENTO CA
95834-1166
US

IV. Provider business mailing address

1936 DEL PASO RD
SACRAMENTO CA
95834-1166
US

V. Phone/Fax

Practice location:
  • Phone: 915-925-6138
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number20829
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number10143
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: