Provider Demographics
NPI:1851758601
Name:HOLMES, MARY FRANCES (CNC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:FRANCES
Last Name:HOLMES
Suffix:
Gender:F
Credentials:CNC
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:FRANCES
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNC
Mailing Address - Street 1:5 BON AIR RD STE D-219
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1143
Mailing Address - Country:US
Mailing Address - Phone:925-946-9011
Mailing Address - Fax:415-924-1770
Practice Address - Street 1:5 BON AIR RD STE D-219
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1143
Practice Address - Country:US
Practice Address - Phone:925-946-9011
Practice Address - Fax:415-924-1770
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133NN1002X133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education