Holly Ann Matticola, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AT 6214 Issued in CA

Practice address

100 Pleasant Hill Ave N
Sebastopol, CA 95472-3104

Phone

(707) 829-3282

Fax

(707) 829-3287

NPI assigned

Oct 27, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sebastopol Physical Therapy and Pilates Studio

  • Physical Therapist
  • Sebastopol, CA
  • NPI 1538201546
  NPD (past)

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1417283383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PLEASANT HILL AVE N",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723104",
            "telephone_number": "707-829-3282",
            "fax_number": "707-829-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PLEASANT HILL AVE N",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723104",
            "telephone_number": "707-829-3282",
            "fax_number": "707-829-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTICOLA",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-27",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT 6214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Donovan Martinez, P.T.
• Mary Good LMFT 97461
• Nicole Marie Matos
• Scott Shigeji Matsuura, LCSW 85567
• Taylor Ashleigh Matthews, MA, LMFT
• Sue B May, RAS
• Boniface Mwele Mbayachi, CMT,NMT
• Monique La Vada MC Math
• Carolyn Louise McAleavy, MFT
• Deborah McCallum, MFT

• Physical Therapy Assistant in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; 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.