Individual provider Active NPI

Paul Leon Hollenbeck, O.T.R.

  • Occupational Therapist
  • Santa Maria, CA
National Provider Identifier
1467788588
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT10320 Issued in CA
Practice address
415 Embassy Ave
Santa Maria, CA 93458-1020
Phone
(805) 361-0621
Fax
(805) 361-0625
NPI assigned
Oct 23, 2009
Last updated
Aug 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT10320 CA Primary

Addresses

Primary practice location

415 Embassy Ave
Santa Maria, CA 93458-1020

Mailing address

415 Embassy Ave
Santa Maria, CA 93458-1020
Phone (805) 361-0621

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
OT10320CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1256256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1467788588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 EMBASSY AVE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934581020",
            "telephone_number": "805-361-0621",
            "fax_number": "805-361-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 EMBASSY AVE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934581020",
            "telephone_number": "805-361-0621",
            "fax_number": "805-361-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLENBECK",
        "first_name": "PAUL",
        "middle_name": "LEON",
        "credential": "O.T.R.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-23",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT10320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; 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.