Provider Demographics
NPI:1306552716
Name:HOLMES, JAMES VINCENT (RN)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:VINCENT
Last Name:HOLMES
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 BRANT ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-1301
Mailing Address - Country:US
Mailing Address - Phone:619-995-4133
Mailing Address - Fax:
Practice Address - Street 1:9601 RIDGEHAVEN CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1686
Practice Address - Country:US
Practice Address - Phone:619-694-7321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA533597163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse