Serenity Jayne Holden, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA23187 Issued in CA

Practice address

1107 W Poplar Ave
Porterville, CA 93257-5839

Phone

(559) 781-7242

Fax

(559) 793-3147

NPI assigned

Sep 5, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medflow PC

  • Emergency Medicine Physician
  • Tulare, CA
  • NPI 1255777504
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1295160588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 W POPLAR AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932575839",
            "telephone_number": "559-781-7242",
            "fax_number": "559-793-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 W POPLAR AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932575839",
            "telephone_number": "559-781-7242",
            "fax_number": "559-793-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "SERENITY",
        "middle_name": "JAYNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA23187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE",
            "identifier": "PA23187",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vince Hernandez, LCSW
• Jasmine Herrera
• Rene Herrera, DDS
• Robin Lisa Herron, RN
• Hanh My Hoang, M.D.
• Chloe Ann Holmes, PPS
• Larissa Marie Holt
• Marissa Holtey, PA-C
• Thomas Martin Honka, D.C.
• Hope Elementary School District

• Physician Assistant in Porterville, CA
• Providers in Porterville, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.