Provider Demographics
NPI:1629562046
Name:HOLMES, LEZLEY (LEP)
Entity Type:Individual
Prefix:
First Name:LEZLEY
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:LEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 NICOLAUS RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-9659
Mailing Address - Country:US
Mailing Address - Phone:916-408-5200
Mailing Address - Fax:
Practice Address - Street 1:2800 NICOLAUS RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-9659
Practice Address - Country:US
Practice Address - Phone:916-408-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool