Provider Demographics
NPI:1619732161
Name:PEARL, HOLLY (MA)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:PEARL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 CAPP ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4697
Mailing Address - Country:US
Mailing Address - Phone:415-821-1427
Mailing Address - Fax:415-821-1426
Practice Address - Street 1:1101 CAPP ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4697
Practice Address - Country:US
Practice Address - Phone:415-821-1427
Practice Address - Fax:415-821-1426
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist