Provider Demographics
NPI:1295901569
Name:HOLMES, KRISTY M (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:M
Last Name:HOLMES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 BARRANCA PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4630
Mailing Address - Country:US
Mailing Address - Phone:949-653-6777
Mailing Address - Fax:949-653-9951
Practice Address - Street 1:4950 BARRANCA PKWY STE 103
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4630
Practice Address - Country:US
Practice Address - Phone:949-653-6777
Practice Address - Fax:949-653-9951
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30854111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor