Provider Demographics
NPI:1396081733
Name:HOLMES, DIANE CHRISTINE
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:CHRISTINE
Last Name:HOLMES
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DIANE
Other - Middle Name:CHRISTINE
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1525 INTERNATIONAL PKWY
Mailing Address - Street 2:
Mailing Address - City:HEATHROW
Mailing Address - State:FL
Mailing Address - Zip Code:32746-7644
Mailing Address - Country:US
Mailing Address - Phone:800-798-6035
Mailing Address - Fax:
Practice Address - Street 1:505 PARNASSUS AVE UCSF MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143
Practice Address - Country:US
Practice Address - Phone:415-353-1756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13510225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist