Organization Active NPI

Holistic Life Care

  • Clinical Psychologist
  • Redondo Beach, CA
National Provider Identifier
1386451383
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
HOLISTIC LIFE CARE
Practice address
415 S Prospect Ave Apt 220
Redondo Beach, CA 90277-3946
Phone
(424) 360-5998
NPI assigned
Dec 12, 2024
Last updated
Dec 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Jacob Rafael DelgadoNPI 1558020339
Title
Co-Founder
Phone
(424) 360-5998

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

415 S Prospect Ave Apt 220
Redondo Beach, CA 90277-3946

Mailing address

415 S Prospect Ave Apt 220
Redondo Beach, CA 90277-3946
Phone (424) 360-5998

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1733961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1386451383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S PROSPECT AVE APT 220",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773946",
            "telephone_number": "424-360-5998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S PROSPECT AVE APT 220",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773946",
            "telephone_number": "424-360-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC LIFE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "DELGADO",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "RAFAEL",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "424-360-5998"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.