MEDICARE: JAMES M HOLT F.N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	438668	CA
2	363LF0000X	Family Nurse Practitioner	FNP13130	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11442452	OTHER	CA	CAQH
2	438668	OTHER	CA	CA RN LICENSE
3	FNP13130	OTHER	CA	LICENSE
4	7246642	OTHER	CA	AETNA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437178191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES M HOLT F.N.P.

Provider Business Mailing Address
First Line	:	7710 BUTTE AVE
Second Line	:
City	:	SUTTER
State	:	CA
Zip	:	95982-2159
Country	:	US
Telephone Number	:	530-674-9061
Fax Number	:

Provider Business Practice Location Address
First Line	:	4062 FLYING C RD STE 41
Second Line	:
City	:	CAMERON PARK
State	:	CA
Zip	:	95682-9664
Country	:	US
Telephone Number	:	530-676-8234
Fax Number	:	530-676-0819

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	09/11/2025

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