MEDICARE: DR. REBECCA LINDA HOLT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0008X	Pediatric Neurodevelopmental Disabilities Physician	A122710	CA
2	2080P0008X	Pediatric Neurodevelopmental Disabilities Physician	DR.0059633	CO

General Provider Information

NPI Number	:	1396037412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA LINDA HOLT M.D.

Provider Business Mailing Address
First Line	:	709 CHELHAM WAY
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93108-1064
Country	:	US
Telephone Number	:	650-814-7228
Fax Number	:

Provider Business Practice Location Address
First Line	:	5333 HOLLISTER AVE
Second Line	:
City	:	GOLETA
State	:	CA
Zip	:	93111-2341
Country	:	US
Telephone Number	:	805-879-4240
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2011
Last Update Date	:	04/15/2022

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