Provider Demographics
NPI:1093796013
Name:HOLLER, JAMI LEE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAMI
Middle Name:LEE
Last Name:HOLLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4524 BABICH AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-1907
Mailing Address - Country:US
Mailing Address - Phone:916-457-2234
Mailing Address - Fax:916-444-6054
Practice Address - Street 1:1990 3RD ST
Practice Address - Street 2:SUITE 600
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-6929
Practice Address - Country:US
Practice Address - Phone:916-457-2234
Practice Address - Fax:916-444-6054
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 37120106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist