Provider Demographics
NPI:1659550861
Name:HOLLAND, VANESSA ROXANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:ROXANNE
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VANESSA
Other - Middle Name:ROXANNE HOLLAND
Other - Last Name:OVREGAARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:VANESSA HOLLAND, MD
Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2020 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 510
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2023
Practice Address - Country:US
Practice Address - Phone:310-971-3376
Practice Address - Fax:310-582-6302
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101766207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology