Healthcare Provider Details

I. General information

NPI: 1851227151
Provider Name (Legal Business Name): HOLLY HANSING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 S DELAWARE ST STE 130
SAN MATEO CA
94403-2394
US

IV. Provider business mailing address

3050 S DELAWARE ST STE 130
SAN MATEO CA
94403-2394
US

V. Phone/Fax

Practice location:
  • Phone: 650-319-8654
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: