Jenoa Lynn Holmes, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA15196 Issued in CA

Practice address

12332 Hesperia Rd Ste a
Victorville, CA 92395-4796

Phone

(760) 243-4009

Fax

(760) 243-3255

NPI assigned

Feb 18, 2007

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Shiloh Medical Center Inc

  • Family Medicine Physician
  • Victorville, CA
  • NPI 1245333830
  Medicare reassignment

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710021134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12539 DULCE ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923928369",
            "telephone_number": "760-949-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12332 HESPERIA RD STE A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954796",
            "telephone_number": "760-243-4009",
            "fax_number": "760-243-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "JENOA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Lynn Holley-Washer, RN
• Jasmine Holley
• Briana Hollier
• Paula Holly
• Allen Holm, LVN
• Sequoia Holyfield
• Jennifer Lynn Hom
• Home Front Pumps
• Diana Hong, MD
• Joseph K Hong, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.