Active NPI
Justin Daniel Holzer, MFT-I
- Marriage & Family Therapist
- Lake Elsinore, CA
National Provider Identifier
1780075341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 85077
- Practice address
- 224 W Graham Ave
Lake Elsinore, CA 92530-3740 - Phone
- (951) 318-1351
- NPI assigned
- Feb 18, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 85077 | CA | Primary |
Addresses
Primary practice location
224 W Graham Ave
Lake Elsinore, CA 92530-3740
Mailing address
5475 Canyon Crest Dr Apt 16
Riverside, CA 92507-6433
Phone (909) 936-0228
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85077 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424217600000",
"number": "1780075341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5475 CANYON CREST DR APT 16",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925076433",
"telephone_number": "909-936-0228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 W GRAHAM AVE",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925303740",
"telephone_number": "951-318-1351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLZER",
"first_name": "JUSTIN",
"middle_name": "DANIEL",
"credential": "MFT-I",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-18",
"last_updated": "2015-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "85077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Elsinore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.