Healthcare Provider Details

I. General information

NPI: 1609876622
Provider Name (Legal Business Name): HOLLY MARIE VILORIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2005
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32392 COAST HWY STE 250
LAGUNA BEACH CA
92651-6776
US

IV. Provider business mailing address

32392 COAST HWY STE. 250
LAGUNA BEACH CA
92651-6776
US

V. Phone/Fax

Practice location:
  • Phone: 949-499-2265
  • Fax: 949-499-2276
Mailing address:
  • Phone: 949-499-2265
  • Fax: 949-499-2276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN611913
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number1997
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP14715
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP14715
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: