Provider Demographics
NPI:1881144855
Name:HOLLAND, ABBY (PHD)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:LYNN
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:3468 MT DIABLO BLVD
Mailing Address - Street 2:SUITE B 201
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3957
Mailing Address - Country:US
Mailing Address - Phone:925-962-9089
Mailing Address - Fax:
Practice Address - Street 1:3468 MT DIABLO BLVD
Practice Address - Street 2:SUITE B 201
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3957
Practice Address - Country:US
Practice Address - Phone:925-962-9089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 11094103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist