Individual provider Active NPI

Rebecca Ann Holley, MS

  • Speech-Language Pathologist
  • Pleasanton, CA
National Provider Identifier
1689450090
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
18103 Issued in CA
Practice address
4471 Stoneridge Dr
Unit a
Pleasanton, CA 94588
Phone
(925) 425-9071
NPI assigned
Sep 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 18103 CA Primary

Addresses

Primary practice location

4471 Stoneridge Dr
Unit a
Pleasanton, CA 94588

Mailing address

1748 Paseo del Cajon
Pleasanton, CA 94566-5909
Phone (925) 699-5408

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
18103CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy at Play, Inc Speech-Language Pathologist PastSince Sep 5, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1689450090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1748 PASEO DEL CAJON",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945665909",
            "telephone_number": "925-699-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4471 STONERIDGE DR",
            "address_2": "UNIT A",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "94588",
            "telephone_number": "925-425-9071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "18103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.