Provider Demographics
NPI:1326678459
Name:HOLMES, GRENISHA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:GRENISHA
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 ARLENE AVE
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2703
Mailing Address - Country:US
Mailing Address - Phone:615-390-6562
Mailing Address - Fax:
Practice Address - Street 1:3585 MAPLE ST STE 248
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-9104
Practice Address - Country:US
Practice Address - Phone:805-743-3109
Practice Address - Fax:805-278-7078
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA823851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical