Individual provider Active NPI

Maria Isabel Holtrop, PSYD

  • Clinical Psychologist
  • Lancaster, CA
National Provider Identifier
1316170004
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 22962 Issued in CA
Practice address
1672 W Avenue J Ste 207
Lancaster, CA 93534-2861
Phone
(661) 225-7166
Fax
(661) 943-3871
NPI assigned
Aug 27, 2009
Last updated
Aug 27, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 22962 CA Primary

Addresses

Primary practice location

1672 W Avenue J Ste 207
Lancaster, CA 93534-2861

Mailing address

1672 W Avenue J Ste 207
Lancaster, CA 93534-2861
Phone (661) 225-7166

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170915000051 CA Practitioner - Clinical Psychologist 9931473915 Practice locations: Lancaster, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1672 W Ave J
Suite 207
Lancaster, CA 93534-2861
Phone (661) 225-7166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 22962CAMDClinical Psychologist
22962CAMDEducational Registered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1316170004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1672 W AVENUE J STE 207",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342861",
            "telephone_number": "661-225-7166",
            "fax_number": "661-943-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1672 W AVENUE J STE 207",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342861",
            "telephone_number": "661-225-7166",
            "fax_number": "661-943-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTROP",
        "first_name": "MARIA",
        "middle_name": "ISABEL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 22962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.