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General NPI Number Information
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NPI Number | 1427348473
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Entity Type | Individual
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Provider Name | KATHLEEN ANN HOLOYDA
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Gender | Female
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 2175 SOUTH AVE
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-7024
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Country | US
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Telephone | 530-543-5799
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Fax | 530-542-2872
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Provider Business Mailing Address
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Address Line | 2170 SOUTH AVE
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-7026
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Country | US
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Telephone | 530-541-3420
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | A129448
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 21257
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License Number State | NV
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