Candace Holly | Santa Rosa, CA • PECOS Search

Candace Holly

Marriage & Family Therapist

Behavioral Health & Social Service Providers

5213 El Mercado Pkwy, Suite A, Santa Rosa, CA 95403-1301

PECOS Enrollment

Based on the most recent information from CMS, provider Candace Holly does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1477879930
Provider Type
Individual
Full Name
Holly, Candace
Title
Ms.
Credential
MA

Gender
Female
Sole Proprietor
Yes
Enumeration Date
4/8/2010
Last Updated
4/8/2010

Contact Information

Practice Location

5213 El Mercado Pkwy, Suite A, Santa Rosa, CA 95403-1301

Unlisted Fax

Mailing Location

5213 El Mercado Pkwy, Suite A, Santa Rosa, CA 95403-1301

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 32289 California