Healthcare Provider Details

I. General information

NPI: 1255829875
Provider Name (Legal Business Name): OLIVIA HONCH LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2018
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E HACKETT RD
MODESTO CA
95358-9415
US

IV. Provider business mailing address

941 WESTMONT CT
MODESTO CA
95356-2060
US

V. Phone/Fax

Practice location:
  • Phone: 209-525-5622
  • Fax:
Mailing address:
  • Phone: 209-595-8329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163289
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: