Provider Demographics
NPI:1174689145
Name:HOLMES-MEREDITH, HOLLY (MA)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:
Last Name:HOLMES-MEREDITH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3702 MT DIABLO BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3686
Mailing Address - Country:US
Mailing Address - Phone:925-283-3941
Mailing Address - Fax:925-825-1868
Practice Address - Street 1:3702 MT DIABLO BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3686
Practice Address - Country:US
Practice Address - Phone:925-283-3941
Practice Address - Fax:925-825-1868
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT21505106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist