Healthcare Provider Details

I. General information

NPI: 1679495436
Provider Name (Legal Business Name): HOLISTIQUE PHYSICAL THERAPY AND WELLNESS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8698 ELK GROVE BLVD # 160
ELK GROVE CA
95624-3300
US

IV. Provider business mailing address

9372 CANTER DR
ELK GROVE CA
95624-9461
US

V. Phone/Fax

Practice location:
  • Phone: 628-888-9818
  • Fax:
Mailing address:
  • Phone: 628-888-9818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. ADINA VERRETT
Title or Position: OWNER/CEO
Credential: PT, DPT
Phone: 628-888-9818