Holly Anton, PH.D.
Individual provider Active NPI Clinical Psychologist · Sebastopol, CA
NPI 1487973665 · NPPES record last updated May 12, 2023
Key facts
- NPI
- 1487973665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY18114 (CA)
- Practice address
- 105 Morris St Ste 200
Sebastopol, CA 95472-3826 - Phone
- (707) 875-6526
- Fax
- (707) 827-3726
- NPI assigned
- May 26, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2000
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
105 Morris St
Suite 200
Sebastopol, CA 95472-3818
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 19, 2026 through Jan 19, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY18114 | CA | MD | Cognitive & Behavioral Psychologist |
| 18114 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter West Bay Medical Foundation | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | PSY18114 | CA | |
| Clinical Psychologist | 103TC0700X | PSY18114 | CA | Yes |
Addresses
Primary practice location
105 Morris St Ste 200
Sebastopol, CA 95472-3826
Mailing address
967 Midpine Way
Sebastopol, CA 95472-5583
Phone (707) 875-6526
Other providers in Sebastopol, CA
- Kathleen Andersen
- Kathryn Anderson
- Andrea E Kirk PHD
- Charles Philip Andrews
- Allie M Andrus McCann
- Muoi M Arnold
- Jessica Jazmin Arzate Pelayo
- Constance J. Ayers
- Maria Bachteal
- Bonnie May Baclawski
All providers in Sebastopol, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.