Provider Demographics
NPI:1477794519
Name:HOLGUIN, ELIZABETH SUSAN (MSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SUSAN
Last Name:HOLGUIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 MARINA BLVD
Mailing Address - Street 2:APT. 106
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4057
Mailing Address - Country:US
Mailing Address - Phone:510-512-3808
Mailing Address - Fax:
Practice Address - Street 1:80 GREAT OAKS BLVD # 180D
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1310
Practice Address - Country:US
Practice Address - Phone:408-363-3000
Practice Address - Fax:408-363-3046
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker