Provider Demographics
NPI:1598983942
Name:HOLMES, RONALD WILLIAM (BA, RN)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:WILLIAM
Last Name:HOLMES
Suffix:
Gender:M
Credentials:BA, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 BURNETT AVE APT 11
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-1350
Mailing Address - Country:US
Mailing Address - Phone:415-826-2072
Mailing Address - Fax:
Practice Address - Street 1:455 BURNETT AVE APT 11
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-1350
Practice Address - Country:US
Practice Address - Phone:415-826-2072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA647812163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult