Individual
DEITDRE A HOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
480 CHADBOURNE RD, FAIRFIELD, CA 94534-9639
(707) 372-9083
Mailing address
480 CHADBOURNE RD, FAIRFIELD, CA 94534-9639
(707) 372-9083
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
—
—
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A23468
CERTIFIED CRIMINAL JUSTICE SPECIALIST
—
Enumeration date
02/05/2010
Last updated
05/06/2025
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