Healthcare Provider Details

I. General information

NPI: 1952229635
Provider Name (Legal Business Name): JOHN FOLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 4TH ST
HERMOSA BEACH CA
90254-4756
US

IV. Provider business mailing address

615 ESPLANADE UNIT 108
REDONDO BEACH CA
90277-4132
US

V. Phone/Fax

Practice location:
  • Phone: 702-494-7641
  • Fax:
Mailing address:
  • Phone: 702-494-7641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number139721
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: