Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 225XM0800X | Mental Health | 13640 | CA |
NPI | 1427475573 |
---|---|
Provider Name | Simmin Holland |
First Address | Oakland, CA 94609-1518 |
Second Address | Oakland, CA 94609-1518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2014 |
Last Update Date | 05/10/2018 |