Individual provider Active NPI

Kathryn Holguin

  • Marriage & Family Therapist
  • Placentia, CA
National Provider Identifier
1588058333
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
100226 Issued in CA
Practice address
101 S Kraemer Blvd Ste 3230
Placentia, CA 92870-6105
Phone
(714) 858-7608
Fax
(714) 993-3501
NPI assigned
Mar 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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 100226 CA Primary

Addresses

Primary practice location

101 S Kraemer Blvd Ste 3230
Placentia, CA 92870-6105

Mailing address

101 S Kraemer Blvd Ste 230
Placentia, CA 92870-6110
Phone (714) 858-7608

Other practice location 1

9033 Washington Blvd
Pico Rivera, CA 90660-3839
Phone (562) 942-9625 ext. 13

Other identifiers 1

IdentifierTypeStateIssuer
106H0000XOtherCAMARRIAGE AND FAMILY THERAPIST

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
I20241028003208 CA Practitioner - Marriage and Family Therapist 8123551207 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100226CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince Aug 23, 2024 Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

Organizations & group practices 1

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": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1588058333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S KRAEMER BLVD STE 230",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928706110",
            "telephone_number": "714-858-7608",
            "fax_number": "714-993-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S KRAEMER BLVD STE 3230",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928706105",
            "telephone_number": "714-858-7608",
            "fax_number": "714-993-3501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9033 Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Pico Rivera",
            "state": "CA",
            "postal_code": "906603839",
            "country_code": "US",
            "telephone_number": "562-942-9625 x13",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLGUIN",
        "first_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-18",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "100226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARRIAGE AND FAMILY THERAPIST",
            "identifier": "106H0000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

Verify at the official NPI Registry.