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General NPI Number Information
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NPI Number | 1881368918
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Entity Type | Individual
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Provider Name | MRS. PRISCILLA A HOLMES
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Gender | Female
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 333 UNIVERSITY AVE STE 200
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City | SACRAMENTO
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State | CA
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Zip | 95825-6540
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Country | US
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Telephone | 916-280-1045
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Fax |
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Provider Business Mailing Address
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Address Line | 9409 SILVER BRIDLE WAY
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City | ELK GROVE
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State | CA
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Zip | 95758-3962
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Country | US
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Telephone | 916-280-1045
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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 | 172A00000X
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Taxonomy Name | Driver
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License Number | C2221045
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License Number State | CA
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