Active NPI
Yancy Holmes
- Mental Health Counselor
- Riverside, CA
National Provider Identifier
1124519517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 3625 14TH St
Riverside, CA 92501-3815 - Phone
- (951) 955-1540
- NPI assigned
- May 22, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
3625 14TH St
Riverside, CA 92501-3815
Mailing address
3625 14TH St
Riverside, CA 92501-3815
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 956000630 | Other | PUBLIC GUARDIAN |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526947200000",
"number": "1124519517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3625 14TH ST",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925013815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3625 14TH ST",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925013815",
"telephone_number": "951-955-1540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "YANCY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-22",
"last_updated": "2018-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PUBLIC GUARDIAN",
"identifier": "956000630",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.