Provider Demographics
NPI:1245613843
Name:MICHEFF, HOLLY LYNN (MS, OTR/L, SWC)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:LYNN
Last Name:MICHEFF
Suffix:
Gender:F
Credentials:MS, OTR/L, SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 HOOFBEAT CT
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5670
Mailing Address - Country:US
Mailing Address - Phone:925-351-1902
Mailing Address - Fax:
Practice Address - Street 1:4848 COTTAGE WAY
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-5612
Practice Address - Country:US
Practice Address - Phone:916-876-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15385225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics