Provider Demographics
NPI:1902392897
Name:HOLGUIN, ALMA J (MA)
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:J
Last Name:HOLGUIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 UTICA AVE STE 259
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3852
Mailing Address - Country:US
Mailing Address - Phone:323-793-3237
Mailing Address - Fax:
Practice Address - Street 1:8300 UTICA AVE STE 259
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3852
Practice Address - Country:US
Practice Address - Phone:323-793-3237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst