Individual provider Active NPI

Holden Lai, SINGLE SUBJECT TEACH

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Daly City, CA
National Provider Identifier
1114225042
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
101Y00000X Issued in CA
Practice address
178 Palisades Dr
178 Palisades Dr
Daly City, CA 94015-4517
Phone
(415) 225-4049
NPI assigned
Mar 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 101Y00000X CA Primary

Addresses

Primary practice location

178 Palisades Dr
178 Palisades Dr
Daly City, CA 94015-4517

Mailing address

178 Palisades Dr
178 Palisades Dr
Daly City, CA 94015-4517
Phone (415) 225-4049

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
101Y00000XCAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1114225042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 PALISADES DR",
            "address_2": "178 PALISADES DR",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940154517",
            "telephone_number": "415-225-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 PALISADES DR",
            "address_2": "178 PALISADES DR",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940154517",
            "telephone_number": "415-225-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAI",
        "first_name": "HOLDEN",
        "credential": "SINGLE SUBJECT TEACH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-01",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "101Y00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.