Basic Information
| Provider Information | |||||||||
| NPI: | 1598277899 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOORE | ||||||||
| FirstName: | HOLLY | ||||||||
| MiddleName: | TRUONG | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 213 QUARRY RD # MC5958 | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943041416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507236469 | ||||||||
| FaxNumber: | 6507250390 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 PASTEUR DR | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943042203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507236469 | ||||||||
| FaxNumber: | 6507250390 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2017 | ||||||||
| LastUpdateDate: | 05/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 95007848 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.