Provider Demographics
NPI:1083711774
Name:HOLDEN, NANCY BELL (ASSOCIATE DEGREE)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:BELL
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:ASSOCIATE DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6225 VERNON WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-5336
Mailing Address - Country:US
Mailing Address - Phone:916-488-7045
Mailing Address - Fax:
Practice Address - Street 1:3307 BROADWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2821
Practice Address - Country:US
Practice Address - Phone:916-454-4242
Practice Address - Fax:916-454-2930
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0307101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0307Medicare UPIN