Active NPI
Sandra Faye Holly, MD
- Psychiatry Physician
- Los Angeles, CA
National Provider Identifier
1386835353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 07747
- Practice address
- 6838 W Sunset Blvd
Los Angeles, CA 90028-7008 - Phone
- (323) 461-3161
- Fax
- (323) 461-5683
- NPI assigned
- Aug 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 07747 | MS | Primary |
Addresses
Primary practice location
6838 W Sunset Blvd
Los Angeles, CA 90028-7008
Mailing address
300 N Farish St Ste C
Jackson, MS 39202-3211
Phone (601) 212-6479
Other practice location 1
300 N Farish St Ste C
Jackson, MS 39202-3211
Phone (601) 212-6479
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01820022 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07747 | MS | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mississippi State Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Jackson, MS
- NPI 1134366867
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753833600000",
"number": "1386835353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 N FARISH ST STE C",
"city": "JACKSON",
"state": "MS",
"postal_code": "392023211",
"telephone_number": "601-212-6479",
"fax_number": "769-572-5697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6838 W SUNSET BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900287008",
"telephone_number": "323-461-3161",
"fax_number": "323-461-5683"
}
],
"practiceLocations": [
{
"address_1": "300 N Farish St Ste C",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "MS",
"postal_code": "392023211",
"country_code": "US",
"telephone_number": "601-212-6479",
"fax_number": "769-572-5697",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLLY",
"first_name": "SANDRA",
"middle_name": "FAYE",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-06",
"last_updated": "2025-07-30",
"certification_date": "2025-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MS",
"license": "07747",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01820022",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.