Provider Demographics
NPI:1992470116
Name:HOLTZMAN, NATHANIEL (NP)
Entity type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:
Last Name:HOLTZMAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:MR
Other - First Name:NATHAN
Other - Middle Name:
Other - Last Name:HOLTZMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:15615 ALTON PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-7308
Mailing Address - Country:US
Mailing Address - Phone:888-588-8995
Mailing Address - Fax:
Practice Address - Street 1:985 N ARIZONA BLVD
Practice Address - Street 2:
Practice Address - City:COOLIDGE
Practice Address - State:AZ
Practice Address - Zip Code:85128-3726
Practice Address - Country:US
Practice Address - Phone:928-216-3681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018009363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health