Provider Demographics
NPI:1457491268
Name:LIEN, HOLLY (LMFT)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:
Last Name:LIEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 PICASSO AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-0546
Mailing Address - Country:US
Mailing Address - Phone:530-220-3433
Mailing Address - Fax:
Practice Address - Street 1:1712 PICASSO AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-0546
Practice Address - Country:US
Practice Address - Phone:530-220-3433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35076106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist