Individual
HOLLY BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
115 CORAL ST, SANTA CRUZ, CA 95060-2104
(831) 454-2080
(831) 454-3424
Mailing address
115 CORAL ST, SANTA CRUZ, CA 95060-2104
(831) 454-2080
(831) 454-3424
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN4053440
CA
207Q00000X
Family Medicine Physician
NP6119
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP6119
NURSE PRACTITIONER #
CA
05
—
RN4053440
—
CA
01
—
ZZZ91891Z
MEDICARE GROUP ID#
CA
01
—
ZZZ91892Z
MEDICARE GROUP ID#
CA
01
—
ZZZ92069Z
MEDICARE GROUP ID#
CA
01
—
ZZZ92073Z
MEDICARE GROUP ID#
CA
Enumeration date
07/25/2006
Last updated
03/07/2023
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