Organization Active NPI

Holistic Nursing Medical Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Ontario, CA
National Provider Identifier
1336893098
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HOLISTIC NURSING MEDICAL INC
Practice address
3350 Shelby St Ste 200
Ontario, CA 91764-5556
Phone
(626) 234-0877
NPI assigned
Feb 10, 2022
Last updated
Feb 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
CHI Man HoNPI 1538610563
Title
Owner
Phone
(626) 234-0877

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

3350 Shelby St Ste 200
Ontario, CA 91764-5556

Mailing address

1623 Hallgreen Dr
Walnut, CA 91789-3427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220823001014 CA Part B Supplier - Clinic/Group Practice 5597148650 Receives reassigned benefits from 4 practitioners
Practice locations: Ontario, CA; Woodland Hills, CA; Riverside, CA; Rancho Cucamonga, CA; Diamond Bar, CA

National Provider Directory

National Provider Directory

Locations

7828 Haven Ave
Rancho Cucamonga, CA 91730
Phone (626) 234-0877

6303 Owensmouth Ave
Fl 10
Woodland Hills, CA 91367
Phone (323) 391-1622

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1336893098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 HALLGREEN DR",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917893427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 SHELBY ST STE 200",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917645556",
            "telephone_number": "626-234-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC NURSING MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "HO",
        "authorized_official_first_name": "CHI MAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-234-0877"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.