Dyllan Nicole Coelho-Holm, MS

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

116665 Issued in CA

Practice address

1375 E Grand Ave # 103-301
Arroyo Grande, CA 93420-2421

Phone

(805) 874-0405

NPI assigned

Sep 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dyllan Nicole Coelho Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1669840856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 E GRAND AVE # 103-301",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934202421",
            "telephone_number": "805-874-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 E GRAND AVE # 103-301",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934202421",
            "telephone_number": "805-874-0405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 S B St",
            "address_purpose": "LOCATION",
            "city": "Lompoc",
            "state": "CA",
            "postal_code": "934366933",
            "country_code": "US",
            "telephone_number": "805-735-4376 x804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 N Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934584319",
            "country_code": "US",
            "telephone_number": "805-928-1707 x132",
            "fax_number": "805-922-4797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COELHO-HOLM",
        "first_name": "DYLLAN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-04",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT-INTERN-96108",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "116665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DYLLAN",
            "last_name": "COELHO",
            "middle_name": "NICOLE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Coast Nursing Anesthesia, Inc
• Coast Radiology Medical Associates a California General Partnership
• Coastal Cardiology a Medical Corp
• Coastal Cardiology a Medical Corp
• Coastal Mobile Physical Therapy Inc
• Kristyn Collins, PHD
• Community Health Centers of the Central Coast Inc
• Community Health Centers of the Central Coast Inc
• Community Health Centers of the Central Coast Inc
• Community Health Centers of the Central Coast, Inc

• All providers in Arroyo Grande, CA
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.