Individual provider Active NPI

Mary Lou Holleman, LMFT

  • Marriage & Family Therapist
  • Santa Cruz, CA
National Provider Identifier
1194813006
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT11946 Issued in CA
Practice address
333 Church St
Ste B
Santa Cruz, CA 95060
Phone
(831) 425-5092
Fax
(831) 425-0225
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT11946 CA Primary

Addresses

Primary practice location

333 Church St
Ste B
Santa Cruz, CA 95060

Mailing address

333 Church St
Ste B
Santa Cruz, CA 95060
Phone (831) 425-5092

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
LMFT11946CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194813006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CHURCH ST",
            "address_2": "STE B",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95060",
            "telephone_number": "831-425-5092",
            "fax_number": "831-425-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CHURCH ST",
            "address_2": "STE B",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95060",
            "telephone_number": "831-425-5092",
            "fax_number": "831-425-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEMAN",
        "first_name": "MARY LOU",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT11946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.