Provider Demographics
NPI:1477089027
Name:HOLLAND ORNSTEIN, JESSICA (LAC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HOLLAND ORNSTEIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:JESSIE
Other - Middle Name:
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2940 SUMMIT ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3416
Mailing Address - Country:US
Mailing Address - Phone:510-926-0577
Mailing Address - Fax:
Practice Address - Street 1:2940 SUMMIT ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3416
Practice Address - Country:US
Practice Address - Phone:510-926-0577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17492171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist