Provider Demographics
NPI:1619063666
Name:SILVERS, HOLLY JACINDA (MPT)
Entity type:Individual
Prefix:MISS
First Name:HOLLY
Middle Name:JACINDA
Last Name:SILVERS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1102 11TH ST
Mailing Address - Street 2:APT. 206
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-5322
Mailing Address - Country:US
Mailing Address - Phone:310-899-0897
Mailing Address - Fax:310-315-5620
Practice Address - Street 1:1301 20TH ST
Practice Address - Street 2:SUITE 150
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2050
Practice Address - Country:US
Practice Address - Phone:310-829-2663
Practice Address - Fax:310-315-5620
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA2374902251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic