Provider Demographics
NPI:1295533164
Name:REDDY, HOLLY (AMFT)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:REDDY
Suffix:
Gender:
Credentials:AMFT
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 30
Mailing Address - Street 2:
Mailing Address - City:SHASTA
Mailing Address - State:CA
Mailing Address - Zip Code:96087-0030
Mailing Address - Country:US
Mailing Address - Phone:530-691-4577
Mailing Address - Fax:
Practice Address - Street 1:150 E CYPRESS AVE STE 200A
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0103
Practice Address - Country:US
Practice Address - Phone:530-691-4577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA151258106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist