Provider Demographics
NPI:1124037775
Name:JONES, HOLLY JUNE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:JUNE
Last Name:JONES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7952 LA RIVIERA DR APT 164
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-1630
Mailing Address - Country:US
Mailing Address - Phone:916-383-3390
Mailing Address - Fax:916-383-3390
Practice Address - Street 1:9261 FOLSOM BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-2561
Practice Address - Country:US
Practice Address - Phone:916-364-1733
Practice Address - Fax:916-364-5255
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT4818225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant