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Individual

MR. REGINALD KEVIN HOLMES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
516 S 14TH ST, GROVER BEACH, CA 93433-2843
(805) 473-7060
Mailing address
516 S 14TH ST, GROVER BEACH, CA 93433-2843
(805) 473-7060

Taxonomy

Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 28015
CA

Other

Enumeration date
01/11/2007
Last updated
07/08/2007
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