Provider Demographics
NPI:1356158026
Name:NORTHCROSS, HOLLY KATHLEEN (PPS, BCBA)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:KATHLEEN
Last Name:NORTHCROSS
Suffix:
Gender:F
Credentials:PPS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 VAN NESS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-2002
Mailing Address - Country:US
Mailing Address - Phone:559-999-1679
Mailing Address - Fax:
Practice Address - Street 1:6041 S ELM AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-6018
Practice Address - Country:US
Practice Address - Phone:559-999-1679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool