Individual provider Active NPI

Pinella Holder, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Laguna Hills, CA
National Provider Identifier
1306958996
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
20A11255 Issued in CA
Practice address
24451 Health Center Dr
Laguna Hills, CA 92653-3689
Phone
(949) 874-1930
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 20A11255 CA Primary

Addresses

Primary practice location

24451 Health Center Dr
Laguna Hills, CA 92653-3689

Mailing address

24451 Health Center Dr
Laguna Hills, CA 92653-3689
Phone (949) 874-1930

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pinellaholder@sjhhandhmg.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151026000550 CA Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 3274687181 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A11255CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Dec 1, 2017 Accepting new patients
Providence Medical Foundation CurrentSince Dec 1, 2017 Accepting new patients
Providence Medical Foundation Current Accepting new patients

Locations

2752 Harrison Ave
#A
Eureka, CA 95501
Phone (707) 268-0190

2675 Harris St
Eureka, CA 95503
Phone (707) 269-0644

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Organizations & group practices 4

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1306958996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24451 HEALTH CENTER DR",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533689",
            "telephone_number": "949-874-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24451 HEALTH CENTER DR",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533689",
            "telephone_number": "949-874-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "PINELLA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A11255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pinellaholder@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "2675 Harris St",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955034806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.