Individual provider Active NPI

Timothy J Holmes

  • Marriage & Family Therapist
  • Redlands, CA
National Provider Identifier
1245733211
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
101892 Issued in CA
Practice address
1812 W Park Ave
Redlands, CA 92373-8014
Phone
(951) 227-8679
NPI assigned
Mar 15, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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 101892 CA Primary

Addresses

Primary practice location

1812 W Park Ave
Redlands, CA 92373-8014

Mailing address

1812 W Park Ave
Redlands, CA 92373
Phone (909) 748-0259

Other practice location 1

22445 Alessandro Blvd Ste 113-114
Moreno Valley, CA 92553-8358
Phone (951) 924-9791

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
101892CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
San Bernardino County Superintendent of Schools Past Accepting new patients
San Bernardino County Superintendent of Schools Past Accepting new patients
Creative Solutions for Kids & Families Past Accepting new patients

Organizations & group practices 3

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": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1245733211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 W PARK AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92373",
            "telephone_number": "909-748-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 W PARK AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738014",
            "telephone_number": "951-227-8679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22445 Alessandro Blvd Ste 113-114",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925538358",
            "country_code": "US",
            "telephone_number": "951-924-9791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-15",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "101892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.