Provider Demographics
NPI:1174338750
Name:HOLMES, ROY ROBYN (LMFT)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:ROBYN
Last Name:HOLMES
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3836 JACARANDAS CT
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-5160
Mailing Address - Country:US
Mailing Address - Phone:209-688-3251
Mailing Address - Fax:
Practice Address - Street 1:3836 JACARANDAS CT
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-5160
Practice Address - Country:US
Practice Address - Phone:209-688-3251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health