Katina Latrice Holliday

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95000731 Issued in CA

Practice address

4200 E Compton Blvd
Compton, CA 90221-3663

Phone

(213) 488-9559

NPI assigned

Aug 8, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• Serenity Recuperative Care, Inc

  • Nursing Facility/Intermediate Care Facility
  • Long Beach, CA
  • NPI 1023527033
  NPD (past) Authorized official

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1003225533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14608 VAN NESS AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902493258",
            "telephone_number": "310-493-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 E COMPTON BLVD",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902213663",
            "telephone_number": "213-488-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIDAY",
        "first_name": "KATINA",
        "middle_name": "LATRICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-08",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000731",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "561948",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Hogan
• Xavier Costolino Hogan Sr.
• Jeremy Holden
• Veverly Juanettia Holiwell, ASW
• Brandon Holley
• Misha Kipanda Hollins
• Bernard Holloway
• Michael D Hooper Jr.
• Hope Alive Counseling Centers LLC
• Hope Alive Counseling Centers, LLC

• All providers in Compton, CA
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.