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PETRONA D HOLLOWAY
NPI 1952239774
Nurse Practitioner - Family in San Diego, CA

Active since May 12, 2026PECOS Enrolled
404 CAMINO DEL RIO S STE 102, SAN DIEGO, CA 92108(800) 316-6314 Get Directions Write a Review

NPPES record last updated: May 12, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Petrona D Holloway NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PETRONA D HOLLOWAY (NPI 1952239774) is an individual family provider in San Diego, California, licensed in California (95039138) and active in the NPI registry since May 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1952239774
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NamePETRONA D HOLLOWAY
Location Address404 CAMINO DEL RIO S STE 102San Diego, CA 92108-3586
Mailing Address404 Camino Del Rio S Ste 102San Diego, CA 92108-3586 · (800) 316-6314
Phone(800) 316-6314
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateMay 12, 2026
NPPES CertifiedMay 12, 2026
✔ NPI 1952239774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95039138
404 CAMINO DEL RIO S STE 102, San Diego, CA 92108
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Petrona D Holloway is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2163988767
PECOS Enrollment IDI20260803001917
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Petrona Holloway reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Carbon Health Medical Group Of California PC
111 mi
Urgent Care
600 E COLORADO BLVD # 120
Pasadena, CA 91101
  • Reassigned Medicare billing, California enrollment
  • 241 clinicians in this Medicare group
NPI 1255957205 (415) 200-2133

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92108 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SANDEEP KAUR
Nurse Practitioner (Family)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (800) 316-6314
ANGELINA STEFANICK
Student in an Organized Health Care Education/Training Program
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (800) 316-6314
LATOYA MICHAELE ROBERSON FNP-BC
Nurse Practitioner (Family)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (855) 313-0885
MARY VAL DAVID KOHISTANI FNP
Nurse Practitioner (Family)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (800) 316-6314
KEEZIA YSABEL MARTINEZ ANTAKLI NP
Nurse Practitioner (Family)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (855) 313-0885
JAYAHMIE DRIO TOLENTINO
Nurse Practitioner (Family)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (800) 316-6314
NICOLE ANN CRUZ DUMANGAN FNP-C
Nurse Practitioner (Primary Care)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (800) 316-6314
JENNIFER ERIN FREITAS MSN, APRN, FNP-C
Nurse Practitioner (Family)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (800) 316-6314

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Petrona Holloway's NPI number?

The NPI number for Petrona Holloway is 1952239774. It was assigned to this individual provider in the NPPES registry on May 12, 2026.

Where is Petrona Holloway located?

Petrona Holloway practices at 404 Camino Del Rio S Ste 102, San Diego, CA 92108. The listed phone number is (800) 316-6314.

What is Petrona Holloway's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Petrona Holloway enrolled in Medicare?

Yes. Petrona Holloway is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Petrona Holloway's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Petrona Holloway reassigns Medicare benefits to Carbon Health Medical Group Of California PC (Pasadena, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Petrona Holloway's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Petrona Holloway was last updated on May 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.