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Individual

HOLLY PORTIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2600 S EL CAMINO REAL STE 100, SAN MATEO, CA 94403-2381
(650) 373-0777
Mailing address
1097 200TH ST, ROCKFORD, IA 50468-8127
(641) 430-1404

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Enumeration date
11/08/2022
Last updated
11/08/2022
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