Healthcare Provider Details
I. General information
NPI: 1952257297
Provider Name (Legal Business Name): KIMBERLY KA YAN HOLMES PPS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9501 LEMON AVE
TEMPLE CITY CA
91780-1305
US
IV. Provider business mailing address
9501 LEMON AVE
TEMPLE CITY CA
91780-1305
US
V. Phone/Fax
- Phone: 626-548-5040
- Fax:
- Phone: 626-548-5040
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TS0200X |
| Taxonomy | School Psychologist |
| License Number | 240161178 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: