Provider Demographics
NPI:1841616422
Name:MOJICA, HOLLY KATHRYN
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:KATHRYN
Last Name:MOJICA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:HOLLY
Other - Middle Name:KATHRYN
Other - Last Name:LUDLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:343 YOLO ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95963-1724
Mailing Address - Country:US
Mailing Address - Phone:530-865-6725
Mailing Address - Fax:530-865-6734
Practice Address - Street 1:343 YOLO ST
Practice Address - Street 2:
Practice Address - City:ORLAND
Practice Address - State:CA
Practice Address - Zip Code:95963-1724
Practice Address - Country:US
Practice Address - Phone:530-865-6725
Practice Address - Fax:530-865-6734
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator