Healthcare Provider Details

I. General information

NPI: 1376364828
Provider Name (Legal Business Name): JANE D HOLMQUIST CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANE D HEIMBICHNER CMT

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ARDEN WAY STE 1
SACRAMENTO CA
95825-2000
US

IV. Provider business mailing address

4177 STOWE WAY
SACRAMENTO CA
95864-6057
US

V. Phone/Fax

Practice location:
  • Phone: 916-488-5560
  • Fax: 916-488-5597
Mailing address:
  • Phone: 916-759-0597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number97598
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: