Provider Demographics
NPI:1134981152
Name:CHANDA HOLMES PLLC
Entity type:Organization
Organization Name:CHANDA HOLMES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANDA
Authorized Official - Middle Name:QUINN
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:916-206-1772
Mailing Address - Street 1:3509 TREELINE ACRES
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:TX
Mailing Address - Zip Code:78154-1964
Mailing Address - Country:US
Mailing Address - Phone:916-206-1772
Mailing Address - Fax:210-998-6193
Practice Address - Street 1:3509 TREELINE ACRES
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:TX
Practice Address - Zip Code:78154-1964
Practice Address - Country:US
Practice Address - Phone:916-206-1772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty