Provider Demographics
NPI:1417640897
Name:HOLDEN, PATRICK JACOB (OD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JACOB
Last Name:HOLDEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 W 5TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-6510
Mailing Address - Country:US
Mailing Address - Phone:805-827-5143
Mailing Address - Fax:
Practice Address - Street 1:1545 W 5TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-6510
Practice Address - Country:US
Practice Address - Phone:805-827-5143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35452152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty