Healthcare Provider Details

I. General information

NPI: 1427705979
Provider Name (Legal Business Name): DANIELLE HOLMES PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2022
Last Update Date: 03/04/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2503 BEECHWOOD DR
PASO ROBLES CA
93446-4730
US

IV. Provider business mailing address

2503 BEECHWOOD DR
PASO ROBLES CA
93446-4730
US

V. Phone/Fax

Practice location:
  • Phone: 805-237-3048
  • Fax:
Mailing address:
  • Phone: 805-237-3048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT20990
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: