Individual provider Active NPI

Holly Ilfeld, PH.D.

  • Clinical Psychologist
  • Roseville, CA
National Provider Identifier
1700878550
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY13211 Issued in CA
Practice address
1380 Lead Hill Blvd
Ste. 110
Roseville, CA 95661-2941
Phone
(916) 481-4585
Fax
(916) 786-3080
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY13211 CA Primary

Addresses

Primary practice location

1380 Lead Hill Blvd
Ste. 110
Roseville, CA 95661-2941

Mailing address

1380 Lead Hill Blvd
Ste. 110
Roseville, CA 95661-2941
Phone (916) 481-4585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY13211CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearthstone Counseling Services, Inc. Clinical PastSince Feb 13, 2006 Accepting new patients

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700878550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 LEAD HILL BLVD",
            "address_2": "STE. 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612941",
            "telephone_number": "916-481-4585",
            "fax_number": "916-786-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 LEAD HILL BLVD",
            "address_2": "STE. 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612941",
            "telephone_number": "916-481-4585",
            "fax_number": "916-786-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILFELD",
        "first_name": "HOLLY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.