Provider Demographics
NPI:1518357177
Name:HOLDEN, ALEXIS (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 EASY ST APT 14
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-5302
Mailing Address - Country:US
Mailing Address - Phone:925-683-4809
Mailing Address - Fax:
Practice Address - Street 1:1060 TWIN DOLPHIN DR
Practice Address - Street 2:SUITE 100
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94065-1133
Practice Address - Country:US
Practice Address - Phone:650-631-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14802225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist