Provider Demographics
NPI:1386324168
Name:GILTON, HOLLY MICHELLE (LMFT)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:MICHELLE
Last Name:GILTON
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:MICHELLE
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 COFFEE RD
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-4233
Mailing Address - Country:US
Mailing Address - Phone:209-872-0600
Mailing Address - Fax:
Practice Address - Street 1:800 COFFEE RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-4233
Practice Address - Country:US
Practice Address - Phone:209-554-6808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA151109106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist