Provider Demographics
NPI:1821034091
Name:SANDERS-HOLLY, CASSANDRA DANAE (DPT)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:DANAE
Last Name:SANDERS-HOLLY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6604
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-8053
Mailing Address - Country:US
Mailing Address - Phone:951-340-0431
Mailing Address - Fax:
Practice Address - Street 1:710 GOLDEN AVE
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-1635
Practice Address - Country:US
Practice Address - Phone:714-993-2093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29564225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist