# CASA SERENA EATING DISORDERS PROGRAM

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Jacquelyn L Holmes
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629468905
- **Authorized official:** MISS JACQUELYN LEE HOLMES MFT (OWNER/DIRECTOR)
- **Authorized official phone:** (925) 682-8252

## Contact information

- **Practice address:** 1868 CLAYTON RD, SUITE 123, CONCORD, CA 94520-2547
- **Practice address phone:** (925) 682-8252
- **Practice address fax:** (925) 682-8313
- **Mailing address:** 1868 CLAYTON RD, SUITE 123, CONCORD, CA 94520-2547
- **Mailing address phone:** (925) 682-8252
- **Mailing address fax:** (925) 682-8313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | MFC25575 | CA | Yes |

## Other

- **Enumeration date:** 01/26/2015
- **Last updated:** 01/26/2015