Provider Demographics
NPI:1558561043
Name:HOLMES, DENISE E
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:E
Last Name:HOLMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19059 BEAR VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-2716
Mailing Address - Country:US
Mailing Address - Phone:760-515-5031
Mailing Address - Fax:760-514-7314
Practice Address - Street 1:19059 BEAR VALLEY RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-2716
Practice Address - Country:US
Practice Address - Phone:760-515-5031
Practice Address - Fax:760-514-7314
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor