Provider Demographics
NPI:1740722198
Name:HOLDSAMBECK & ASSOCIATES
Entity type:Organization
Organization Name:HOLDSAMBECK & ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:DELGADO MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-979-9941
Mailing Address - Street 1:2342 PROFESSIONAL PARKWAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455
Mailing Address - Country:US
Mailing Address - Phone:805-979-9941
Mailing Address - Fax:805-222-3041
Practice Address - Street 1:66-437 KAMEHAMEHA HWY #95
Practice Address - Street 2:SUITE 300
Practice Address - City:HALEIWA
Practice Address - State:HI
Practice Address - Zip Code:96712
Practice Address - Country:US
Practice Address - Phone:808-518-4565
Practice Address - Fax:805-222-3041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty