Cynthia Elaine Ahlholm, PT MS OCS
Individual provider Active NPI Physical Therapist · Santa Monica, CA
NPI 1295765303 · NPPES record last updated Oct 31, 2018
Key facts
- NPI
- 1295765303
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT22538 (CA)
- Practice address
- 2601 Ocean Park Blvd
Ste 302
Santa Monica, CA 90405-5215 - Phone
- (310) 913-8480
- NPI assigned
- Jul 4, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22538 | CA | MD | Clinical Social Worker |
| PT22538 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ethan Waldman Physical Therapy & Wellness Inc | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT22538 | CA | Yes |
Addresses
Primary practice location
2601 Ocean Park Blvd
Ste 302
Santa Monica, CA 90405-5215
Mailing address
11425 Rochester Ave
Apt 19
Los Angeles, CA 90025
Phone (310) 477-0647
Other providers in Santa Monica, CA
- Yesenia Aguilar Silvan
- Blossom Dawn Vencer Aguirre
- Stephanie Marie Aguirre
- Anabelle Ahdoot
- Edmond Ahdoot
- Lauren Ahlquist
- Seth Austin Ahlquist
- Daniya R Ahmed
- Rasha Ahmed
- Cassandra Ahn
All providers in Santa Monica, CA · Physical Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.