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Individual

MR. JASPER CORY HOLLINGSWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
659 CHERRY ST, SANTA ROSA, CA 95404-4280
(707) 526-8300
(707) 526-8310
Mailing address
1026 MARIA DR, PETALUMA, CA 94954-7439
(707) 291-3536
(707) 766-9268

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
A068730
CA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
A068730
CA

Other

Enumeration date
08/04/2006
Last updated
12/20/2021
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