Individual provider Active NPI

Renee Caprice Hollandsworth, D.P.T.

  • Physical Therapist
  • Laguna Hills, CA
National Provider Identifier
1124202809
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
34213 Issued in CA
Practice address
23293 S Pointe Dr
Laguna Hills, CA 92653-1447
Phone
(949) 770-5843
NPI assigned
Dec 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 34213 CA Primary

Addresses

Primary practice location

23293 S Pointe Dr
Laguna Hills, CA 92653-1447

Mailing address

1067 N Lincoln St
Orange, CA 92867-5843
Phone (714) 532-3493

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
34213CAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1124202809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 N LINCOLN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928675843",
            "telephone_number": "714-532-3493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23293 S POINTE DR",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531447",
            "telephone_number": "949-770-5843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLANDSWORTH",
        "first_name": "RENEE",
        "middle_name": "CAPRICE",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "34213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.