Provider Demographics
NPI:1306971148
Name:HOLSCHER, DONNA
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:HOLSCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 SISTER MARY COLUMBA DR
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-4356
Mailing Address - Country:US
Mailing Address - Phone:530-527-0414
Mailing Address - Fax:
Practice Address - Street 1:20833 LONG BRANCH DR
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:CA
Practice Address - Zip Code:96022-8701
Practice Address - Country:US
Practice Address - Phone:530-347-3418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG59568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM53957FMedicaid
CAGR0089252Medicaid
CAZZZ20791ZMedicare Oscar/Certification
CA553957Medicare ID - Type UnspecifiedRHC MCARE
CAGR0089252Medicaid