Provider Demographics
NPI:1346389434
Name:HOLM, ANN MARIE (PT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:HOLM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 EL CAMINO REAL STE A
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94027-4129
Mailing Address - Country:US
Mailing Address - Phone:650-395-7422
Mailing Address - Fax:650-649-1744
Practice Address - Street 1:1900 EL CAMINO REAL STE A
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94027-4129
Practice Address - Country:US
Practice Address - Phone:650-395-7422
Practice Address - Fax:650-649-1744
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2024-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24272225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist