Provider Demographics
NPI:1255753307
Name:HOLDREGE, KAREN JEAN (RN, MSN, NP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:JEAN
Last Name:HOLDREGE
Suffix:
Gender:F
Credentials:RN, MSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7606 HOLLISTER AVE UNIT 311
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-2462
Mailing Address - Country:US
Mailing Address - Phone:805-202-6241
Mailing Address - Fax:
Practice Address - Street 1:201 S MILLER ST STE 103
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5248
Practice Address - Country:US
Practice Address - Phone:805-314-2175
Practice Address - Fax:805-314-2175
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-09
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA519838363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA602862201OtherUNITEDHEALTHCARE